Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.

<h4>Objective</h4>To examine the prevalence and predictors of infection related never events (NE) associated with spinal fusion procedures (SFP) in children (age < = 18 years) in the United States.<h4>Methods</h4>We performed a retrospective analysis of the Nationwide Inpa...

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Autores principales:	Veerajalandhar Allareddy, Veerasathpurush Allareddy, Romesh P Nalliah, Sankeerth Rampa, Min Kyeong Lee
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/44506732206e419cb5428b528c682ac6
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spelling	oai:doaj.org-article:44506732206e419cb5428b528c682ac62021-11-18T08:48:23ZInfection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.1932-620310.1371/journal.pone.0077540https://doaj.org/article/44506732206e419cb5428b528c682ac62013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24223715/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To examine the prevalence and predictors of infection related never events (NE) associated with spinal fusion procedures (SFP) in children (age < = 18 years) in the United States.<h4>Methods</h4>We performed a retrospective analysis of the Nationwide Inpatient Sample for the years 2004 to 2008. All pediatric hospitalizations that underwent SFP were selected for analysis. The main outcomes measures include occurrence of certain NE's. The association between the occurrence of a NE and factors (patient & hospital related) were examined using multivariable logistic regression analysis.<h4>Results</h4>Of 56,465 hospitalizations, 61.7% occurred among females. The average age was 13.7 y and two-thirds were whites. The major insurance payer was private insurance (67.4%). About 82% of all hospitalizations occurred on an elective basis. Teaching hospitals accounted for a majority of hospitalizations (87.9%). Two-thirds were posterior fusion techniques, 52.3% had underlying musculoskeletal deformities, and the most frequently present co-morbid conditions (CMC) included paralysis (10.9%), chronic pulmonary disease (9.7%), and fluid/electrolyte disorders (7.6%). Overall rate of occurrence of a NE was 4.8%. Post-operative pneumonia was the most frequently occurring NE (2.9%). Female gender (OR = 0.78) and elective admissions (OR = 0.66) were associated with lower risk of NE occurrence. Medicaid coverage (OR = 1.46), primary diagnosis of other acquired deformities (OR = 1.82), spinal cord injury (OR = 6.94), other nervous system disorders (OR = 2.84) were associated with higher risk of NE occurrence. Among CMC, those with chronic blood loss anemia (OR = 2.57), coagulopathy (OR = 1.97), depression (OR = 2), drug abuse (OR = 3.71), fluid/electrolyte disorders (OR = 2.62), neurological disorders (OR = 1.72), paralysis (OR = 1.75), renal failure (OR = 5.45), and weight loss (OR = 4.61) were risk factors for higher odds of a NE occurrence. Hospital teaching status, region, hospital size, and patient race did not influence the occurrence of NE.<h4>Conclusion</h4>The never events examined in the current study occurred in 4.8% of children hospitalized with SFP. Certain predictors of NE are identified in this study.Veerajalandhar AllareddyVeerasathpurush AllareddyRomesh P NalliahSankeerth RampaMin Kyeong LeePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e77540 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Veerajalandhar Allareddy Veerasathpurush Allareddy Romesh P Nalliah Sankeerth Rampa Min Kyeong Lee Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.
description	<h4>Objective</h4>To examine the prevalence and predictors of infection related never events (NE) associated with spinal fusion procedures (SFP) in children (age < = 18 years) in the United States.<h4>Methods</h4>We performed a retrospective analysis of the Nationwide Inpatient Sample for the years 2004 to 2008. All pediatric hospitalizations that underwent SFP were selected for analysis. The main outcomes measures include occurrence of certain NE's. The association between the occurrence of a NE and factors (patient & hospital related) were examined using multivariable logistic regression analysis.<h4>Results</h4>Of 56,465 hospitalizations, 61.7% occurred among females. The average age was 13.7 y and two-thirds were whites. The major insurance payer was private insurance (67.4%). About 82% of all hospitalizations occurred on an elective basis. Teaching hospitals accounted for a majority of hospitalizations (87.9%). Two-thirds were posterior fusion techniques, 52.3% had underlying musculoskeletal deformities, and the most frequently present co-morbid conditions (CMC) included paralysis (10.9%), chronic pulmonary disease (9.7%), and fluid/electrolyte disorders (7.6%). Overall rate of occurrence of a NE was 4.8%. Post-operative pneumonia was the most frequently occurring NE (2.9%). Female gender (OR = 0.78) and elective admissions (OR = 0.66) were associated with lower risk of NE occurrence. Medicaid coverage (OR = 1.46), primary diagnosis of other acquired deformities (OR = 1.82), spinal cord injury (OR = 6.94), other nervous system disorders (OR = 2.84) were associated with higher risk of NE occurrence. Among CMC, those with chronic blood loss anemia (OR = 2.57), coagulopathy (OR = 1.97), depression (OR = 2), drug abuse (OR = 3.71), fluid/electrolyte disorders (OR = 2.62), neurological disorders (OR = 1.72), paralysis (OR = 1.75), renal failure (OR = 5.45), and weight loss (OR = 4.61) were risk factors for higher odds of a NE occurrence. Hospital teaching status, region, hospital size, and patient race did not influence the occurrence of NE.<h4>Conclusion</h4>The never events examined in the current study occurred in 4.8% of children hospitalized with SFP. Certain predictors of NE are identified in this study.
format	article
author	Veerajalandhar Allareddy Veerasathpurush Allareddy Romesh P Nalliah Sankeerth Rampa Min Kyeong Lee
author_facet	Veerajalandhar Allareddy Veerasathpurush Allareddy Romesh P Nalliah Sankeerth Rampa Min Kyeong Lee
author_sort	Veerajalandhar Allareddy
title	Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.
title_short	Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.
title_full	Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.
title_fullStr	Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.
title_full_unstemmed	Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.
title_sort	infection related never events in pediatric patients undergoing spinal fusion procedures in united states: prevalence and predictors.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/44506732206e419cb5428b528c682ac6
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Infection related never events in pediatric patients undergoing spinal fusion procedures in United States: prevalence and predictors.

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