Evidence map›Paper›PMID 39912379›Full record

ArticlePaediatric anaesthesia2025

Association of Cerebral Palsy With Unanticipated Admission Following Pediatric Ambulatory Surgery.

Nina Shamansky, Christian Mpody, Olubukola O Nafiu, Joseph D Tobias, Brittany L Willer

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Article in Paediatric anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Nina ShamanskyCollege of Medicine, the Ohio State University, Columbus, Ohio, USA.
Christian MpodyDepartment of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
Olubukola O NafiuDepartment of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
Joseph D TobiasDepartment of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
Brittany L WillerDepartment of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.ORCID 0000-0002-4123-6867

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCerebral palsy, a neurologic disorder caused by damage to the developing brain, is a leading cause of childhood disability. Due to musculoskeletal, movement, and secondary impairments, children with cerebral palsy often require surgical care. With the growing cost of surgical care, many children with cerebral palsy are scheduled for surgery in an ambulatory setting. Whether cerebral palsy increases the risk of unanticipated admission (a critical quality indicator of care) following ambulatory surgery has not been characterized. Our objective was to determine the association of cerebral palsy with unanticipated admission following pediatric ambulatory surgery.

methodsWe used the Pediatric Health Information System (PHIS) database to evaluate a retrospective cohort of children (< 18 years) who underwent scheduled ambulatory operations between January 1, 2010 and December 31, 2022. The primary outcome was unanticipated admission. Using log-binomial regression models, we estimated the relative risk and 95% confidence intervals for unanticipated admission, comparing patients with and without cerebral palsy. To account for confounding variables, we performed a 1:1 propensity score matching without replacement.

resultsA total of 1 954 108 children underwent ambulatory surgeries during the study period. Of these, 4.1% required unanticipated admission. The overall incidence of unanticipated admission was significantly higher among children with cerebral palsy than in those without (9.8% vs. 4.0%; p < 0.001). This association remained significant after multivariable adjustment (relative risk: 1.73; 95% CI: 1.59-1.87, p < 0.001).

conclusionAlthough cerebral palsy is not a contraindication for ambulatory surgery in children, it is significantly associated with the risk of unanticipated hospital admissions. This underscores the need for careful preoperative clinical site of care selection in this vulnerable patient population. LEVEL OF EVIDENCE: Level II.

Indexed as

Ambulatory Surgical ProceduresCerebral PalsyPatient AdmissionPostoperative ComplicationsAdolescentChildChild, PreschoolCohort StudiesFemaleHumansInfantMaleRetrospective Studiesambulatory surgical procedurescerebral palsychild

Identifiers

PMID39912379
PMCPMC11975177

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