Introduction: surgical intervention for pediatric scoliosis is a common and effective approach that greatly enhances quality of life. Despite the general safety of these procedures, postoperative complications can arise, posing significant management challenges. This study aimed to identify patient characteristics associated with early postoperative complications within the first 48 hours following spinal deformity surgery. Additionally, it assessed the types, prevalence, and severity of these complications and explored contributing risk factors. Methods: we conducted a retrospective cohort study including all children aged 8–18 years who underwent spinal deformity correction and were admitted to the largest tertiary PICU in Israel from 2010 to 2021. Clinical and laboratory data were collected from electronic medical records and analyzed systematically. Statistical methods were used to determine risk factors associated with immediate postoperative complications occurring within the first 48 hours after surgery. Results: Eighty-one pediatric patients who underwent spinal deformity surgery were analyzed; 41 (50%) experienced complications within 48 hours postoperatively. Complication risk was higher in those with comorbidities (RR=1.8), elevated serum lactate (>2 mmol/L, RR=7.3), significant drops in hemoglobin (RR=4.56), increased CRP (>20 mg/dL, RR=1.71), and low albumin (< 3 mg/dL, RR=1.57). A predictive model incorporating these factors (AUC=0.74) allowed accurate stratification of patients into low- and high-risk groups, with risk scores above 4 points yielding 100% specificity and positive predictive value for complications at PICU admission. Conclusions: several factors were identified as predictors of increased risk for complications within 48 hours after pediatric spinal deformity surgery. A straightforward predictive model utilizing these variables showed promising performance for early risk stratification upon PICU admission. Early identification of high-risk patients may facilitate improved care, reduce unnecessary PICU stays, lower healthcare costs, and minimize hospital length of stay. Further validation and refinement of this model are needed to enhance its accuracy and generalizability.
Lerner et al. (Sun,) studied this question.