ArticleJournal of pediatric urology2022
Predicting postoperative complications in pediatric surgery: A novel pediatric comorbidity index.
Article in Journal of pediatric urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Parental preferences for pediatric surgical facility centralization: insights from a discrete choice experiment.Pediatric surgery international · 2025Article
- Children Comorbidity Score, a Simple Predictor for In-hospital Mortality: A Nationwide Inpatient Database Study in Japan.JMA journal · 2025Article
- Surgical complication index for pediatric patients (SCIPP): A novel pediatric frailty index predicting postoperative complications in a study of 133 pediatric neurosurgical patients.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
INTRODUCTION/
backgroundComorbidity-driven surgical risk assessment is essential for informed patient counseling, risk-stratification, and outcomes-based health-services research. Existing mortality-focused comorbidity indices have had mixed success at risk-adjustment in children.
objectiveTo develop a new comorbidity-driven multispecialty surgical risk index predicting 30-day postoperative complications in children. STUDY
designThis retrospective cohort study investigated children undergoing surgical procedures across seven specialties in 2014-2015 using the MarketScan® Research databases. The risk index was derived separately for ambulatory and inpatient surgery patients using logistic regression with backward selection. The performance of the novel index in discriminating postoperative complications vis-à-vis three existing comorbidity indices was compared using bootstrapping and area under the receiver operating characteristics curves (AUC).
resultsWe identified 190,629 ambulatory and 22,633 inpatient patients. The novel index had the best performance for discriminating postoperative complications for inpatients (AUC 0.76, 95% confidence interval [CI] 0.75-0.77) relative to the Charlson Comorbidity Index (CCI, 0.56, 95% CI 0.56-0.57), Van Walraven Index (VWI, 0.60, 95% CI 0.60-0.61), and Rhee Score (RS, 0.69, 95% CI 0.68-0.70). In the ambulatory cohort, the novel index outperformed all three existing indices, though none demonstrated excellent discriminatory ability for complications (novel score 0.68, 95% CI 0.67-0.68; CCI 0.53, 95% CI 0.52-0.53; VWI 0.53, 95% CI 0.52-0.53; RS 0.50, 95% CI 0.49-0.50). DISCUSSION: In both inpatient and ambulatory pediatric settings, our novel comorbidity index demonstrated better performance at predicting postoperative complications than three widely used alternatives. This index will be useful for research and may be adaptable to clinical settings to identify high-risk patients and facilitate perioperative planning.
conclusionWe developed a novel pediatric comorbidity index with better performance at predicting postoperative complications than three widely used alternatives.
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