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We aimed to identify the frequency and predictive factors of co-occurring perioperative complications in these children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective database cohort study, we identified children (ages 10\u201318\u00a0years) with neuromuscular scoliosis who underwent elective spinal fusion in 2012\u20132020 from the National Surgical Quality Improvement Program-Pediatric database. The rates of co-occurring complications within 30\u00a0days were calculated, and associated factors were identified by logistic regression analysis. Correlation between a number of complications and outcomes was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Approximately 11% (709\/6677 children with neuromuscular scoliosis undergoing spinal fusion had co-occurring complications: 7% experienced two complications and 4% experienced\u2009\u2265\u20093. The most common complication was bleeding\/transfusion (80%), which most frequently co-occurred with pneumonia (24%) and reintubation (18%). Surgical time\u2009\u2265\u2009400\u00a0min (odds ratio (OR) 1.49 [95% confidence interval (CI) 1.25\u20131.75]), fusion\u2009\u2265\u200913 levels (1.42 [1.13\u20131.79]), and pelvic fixation (OR 1.21 [1.01, 1.44]) were identified as procedural factors that independently predicted concurrent complications. Clinical risk factors for co-occurring complications included an American Society of Anesthesiologist physical status classification\u2009\u2265\u20093 (1.73 [1.27\u20132.37]), structural pulmonary\/airway abnormalities (1.24 [1.01\u20131.52]), impaired cognitive status (1.80 [1.41\u20132.30]), seizure disorder (1.36 [1.12\u20131.67]), hematologic disorder (1.40 [1.03\u20131.91], preoperative nutritional support (1.34 [1.08\u20131.72]), and congenital malformations (1.20 [1.01\u20131.44]). Preoperative tracheostomy was protective against concurrent complications (0.62 [0.43\u20130.89]). Significant correlations were found between number of complications and length of stay, non-home discharge, readmissions, and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Longer surgical time (\u2265\u2009400\u00a0min), fusion\u2009\u2265\u200913 levels and pelvic fixation are surgical risk factors independently associated with co-occurring complications, which were associated with poorer patient outcomes. Recognizing identified nonmodifiable risk factors might also be important for preoperative planning and risk stratification of children with neuromuscular scoliosis requiring spinal fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level IV evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-023-00813-8","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T09:03:29Z","timestamp":1707469409000},"page":"727-738","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Frequency and predictors of complication clustering within 30\u00a0days of spinal fusion surgery: a study of children with neuromuscular scoliosis"],"prefix":"10.1007","volume":"12","author":[{"given":"Sujay","family":"Rajkumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv R.","family":"Iyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian","family":"Plonsker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Brandel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Gonda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus D.","family":"Mazur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald J.","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela M.","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4496-7622","authenticated-orcid":false,"given":"Vijay M.","family":"Ravindra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"813_CR1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.bpa.2015.11.005","volume":"30","author":"T Ailon","year":"2016","unstructured":"Ailon T, Sure DR, Smith JS, Shaffrey CI (2016) Surgical considerations for major deformity correction spine surgery. 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This work was prepared as part of my official duties. Title 17, U.S.C., \u00a7105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C., \u00a7101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person\u2019s official duties.\u201d","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Copyright statement"}}]}}