Validation of the pediatric surgical risk assessment scoring system

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorWOODA, Guilherme
dc.contributor.authorBARAYAN, Ghassan
dc.contributor.authorSANCHEZ, Daniela C. J.
dc.contributor.authorINOUE, Gustavo N. C.
dc.contributor.authorBUCHALLA, Carlos A. O.
dc.contributor.authorROSSINI, Guilherme A.
dc.contributor.authorTREVISANI, Lorenzo F. M.
dc.contributor.authorPRADO, Rogerio Ruscitto do
dc.contributor.authorPASSEROTTI, Carlo C.
dc.contributor.authorNGUYEN, Hiep T.
dc.date.accessioned2014-01-28T22:29:56Z
dc.date.available2014-01-28T22:29:56Z
dc.date.issued2013
dc.description.abstractBackground: Within the adult population, there exist numerous validated risk stratification tools aimed at predicting postoperative outcomes using preoperative and intraoperative parameters. However, similar tools for the pediatric population are scarce. We previously developed and reported on a scoring system to predict postoperative complications in children undergoing surgery at Boston Children's Hospital. The objective of this study was to validate our scoring system to determine its effectiveness in identifying children at risk for major complications or death within 30 days following surgery. Study Design: A computer program randomly selected 2015 out of 11,734 patients who underwent surgery at our institution in 2009. The severity of the complications was graded based on the Clavien classification system, with major complications being a grade III or higher. The Preoperative Complication Score (PCS) and the Overall Complication Score (OCS) were calculated for all patients, and Receiver Operating Characteristic (ROC) curves were generated for each scoring system. Results: The overall incidence of major complications was 3.9% (79 patients). Proportionally, cardiac surgery had the highest percentage of major complications (20% of the performed surgeries). Both PCS and OCS demonstrated excellent correlation with postoperative outcomes with c-statistic values of 0.740 (CI 0.682-0.800, p < 0.001) and 0.767 (CI 0.712-0.822, p < 0.001) respectively. Conclusions: We determined that both the PCS and OCS are effective in identifying children at risk for major complications and death following surgery. Further studies will be needed to determine if these scoring systems are applicable to children undergoing surgery at other institutions and if the use of the scoring systems would result in improved clinical outcomes and reduced costs.
dc.description.indexMEDLINE
dc.identifier.citationJOURNAL OF PEDIATRIC SURGERY, v.48, n.10, p.2017-2021, 2013
dc.identifier.doi10.1016/j.jpedsurg.2013.04.017
dc.identifier.issn0022-3468
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/4374
dc.language.isoeng
dc.publisherW B SAUNDERS CO-ELSEVIER INC
dc.relation.ispartofJournal of Pediatric Surgery
dc.rightsrestrictedAccess
dc.rights.holderCopyright W B SAUNDERS CO-ELSEVIER INC
dc.subjectPediatric
dc.subjectSurgical complications
dc.subjectScoring system
dc.subject.othermortality
dc.subject.otherclassification
dc.subject.othercomplications
dc.subject.otherprediction
dc.subject.otherapache
dc.subject.othertrial
dc.subject.wosPediatrics
dc.subject.wosSurgery
dc.titleValidation of the pediatric surgical risk assessment scoring system
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalWOODA, Guilherme:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA; Univ Sao Paulo FMUSP, Dept Urol, Coll Med, Sao Paulo, Brazil
hcfmusp.author.externalBARAYAN, Ghassan:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA
hcfmusp.author.externalSANCHEZ, Daniela C. J.:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA
hcfmusp.author.externalINOUE, Gustavo N. C.:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA
hcfmusp.author.externalBUCHALLA, Carlos A. O.:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA
hcfmusp.author.externalROSSINI, Guilherme A.:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA
hcfmusp.author.externalTREVISANI, Lorenzo F. M.:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA
hcfmusp.author.externalPRADO, Rogerio Ruscitto do:Univ Sao Paulo FMUSP, Dept Urol, Coll Med, Sao Paulo, Brazil
hcfmusp.author.externalNGUYEN, Hiep T.:Robot Surg Res & Training Ctr, Dept Urol, Boston, MA USA; Boston Childrens Hosp, Boston, MA USA
hcfmusp.citation.scopus14
hcfmusp.contributor.author-fmusphcCARLO CAMARGO PASSEROTTI
hcfmusp.description.beginpage2017
hcfmusp.description.endpage2021
hcfmusp.description.issue10
hcfmusp.description.volume48
hcfmusp.origemWOS
hcfmusp.origem.pubmed24094950
hcfmusp.origem.scopus2-s2.0-84885113267
hcfmusp.origem.wosWOS:000325332200004
hcfmusp.publisher.cityPHILADELPHIA
hcfmusp.publisher.countryUSA
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hcfmusp.scopus.lastupdate2024-05-10
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