Surgical Outcomes for Pediatric Patients with Neurodevelopmental Disorders and Inflammatory Bowel Disease

Neurodevelopmental disorders (NDD) are associated with inflammatory bowel disease (IBD). For children with NDD, difficulties with assessment and communication can complicate care. We sought to define the perioperative outcomes for children with NDD and IBD who undergo colectomy.

Using the National Surgical Quality Improvement Pediatric (NSQIP-P) database from 2019 to 2023 we identified children with IBD who underwent total or partial colectomy. NDD diagnosis was identified using the NSQIP-P variable for "developmental delay". Outcomes were analyzed using Fisher's exact test for categorical outcomes and Rank Sum test for contiguous variables, followed by multivariable logistic regression.

Of 1,978 pediatric patients who underwent a colectomy, 71 (3.6%) were identified as having NDD. NDD patients had longer average hospital lengths of stays (LOS) prior to their operation (9.66 vs. 3.71 days, p=0.0045) but had no difference in LOS post-operatively. They required more nutritional support pre-operatively (aOR 2.30, 95% 1.38-3.83, p=0.001) but were not more likely to be discharged on total parenteral nutrition (aOR 2.2, 95% CI 0.9-5.0, p=0.07). Patients with NDD were more than eight times as likely to be diagnosed with pneumonia postoperatively (aOR 8.84, 95% CI 2.15-36.29, p=0.003). Other findings that were significant on univariate analysis did not persist after multivariable analysis.

NDD patients have different hospital courses compared to their non-NDD counterparts when undergoing colectomies for IBD. However, this study is limited by the broad NSQIP definition of NDD. Further research would benefit from granularity of NDD diagnoses and perioperative variables in national databases.