{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:52:47Z","timestamp":1747187567132,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Posterior fossa decompression for Chiari I Malformation is a common pediatric neurosurgical procedure. We sought to identify the impact of anesthesia\u2010related intraoperative complications on unanticipated admission to the intensive care unit and outcomes following posterior fossa decompression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records of all patients &lt;18\u2009years who underwent surgery for Chiari I malformation between 1\/1\/09 and 1\/31\/21 at the Ann &amp; Robert H. Lurie Children's Hospital of Chicago were included. Records were reviewed for patient characteristics, anesthesia\u2010related intraoperative complications, postoperative complications, and surgical outcomes. The primary outcome was the incidence of unanticipated admission to the intensive care unit, and the primary variable of interest was an anesthesia\u2010related intraoperative complication. Patient, surgical characteristics, and year of surgery were also compared between patients with and without an unanticipated admission to the intensive care unit, and a multi\u2010variable adjusted estimate of odds of unanticipated admission to the intensive care unit admission following an anesthesia\u2010related intraoperative complication was performed. Secondary outcomes included anesthesia factors associated with an anesthesia\u2010related intraoperative event, and postoperative complications and surgical outcomes between patients admitted to the intensive care unit and those who were not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred ninety\u2010six patients with Chiari I Malformation were identified. Clinical characteristics associated with an unanticipated admission to the intensive care unit were younger age, American Society of Anesthesiologist (ASA) physical status &gt;2 and an anesthesia\u2010related intraoperative complication. 29 anesthesia\u2010related intraoperative complications were observed in 25 patients (8.4%). Two of 25 patients (8%) with an anesthesia\u2010related intraoperative complication compared with 3 of 271 (1%) patients without anesthesia\u2010related intraoperative complication had an unanticipated admission to the intensive care unit, odds ratio 7.8 (95% CI 1.2\u201348.8, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.010). When adjusted for age, sex, ASA physical status, presenting symptoms, concomitant syringomyelia, previous decompression surgery and year of surgery, the odds ratio for an unanticipated admission to the intensive care unit following an anesthesia\u2010related intraoperative complication was 5.9 (95% CI 0.51\u201359.6, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.149). There were no differences in surgical outcomes between patients with or without an unanticipated admission to the intensive care unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study demonstrates that although anesthesia\u2010related intraoperative complications during posterior fossa decompression are infrequent, they are associated with an increased risk of an unanticipated admission to the intensive care unit.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14496","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T12:04:56Z","timestamp":1653307496000},"page":"937-945","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient and operative factors associated with unanticipated intensive care admission and outcomes following posterior fossa decompressions in children: A retrospective study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-4410","authenticated-orcid":false,"given":"Hubert A.","family":"Benzon","sequence":"first","affiliation":[{"name":"Department of Pediatric Anesthesiology, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Tantoco","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Longhini","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3142-1898","authenticated-orcid":false,"given":"John","family":"Hajduk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Saratsis","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Riley Hospital for Children, and Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhanam","family":"Suresh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0966-5311","authenticated-orcid":false,"given":"Robert J.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Rush University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narasimhan","family":"Jagannathan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000612"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001481"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002454"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2253-14-71"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.03096.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.PEDS14295"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2009.01.003"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-009-0913-8"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005860000149"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.11.PEDS1097"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0967-5868(96)90081-8"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-002-0574-3"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-011-0685-2"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-008-0700-y"},{"key":"e_1_2_9_16_1","first-page":"184","article-title":"Dura\u2010splitting decompression of the craniocervical junction: reduced operative time, hospital stay, and cost with equivalent early outcome","volume":"101","author":"Limonadi FM","year":"2004","journal-title":"J Neurosurg"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31828ca1ed"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3171\/PED\/2008\/2\/7\/052"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-003-0883-1"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/2011.5.PEDS10362"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.6.1212"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000028777"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2002.97.5.1018"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000120811"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.12.PEDS10379"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-011-0731-0"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14496","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pan.14496","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14496","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T14:01:49Z","timestamp":1692626509000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,3]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1111\/pan.14496"],"URL":"https:\/\/doi.org\/10.1111\/pan.14496","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"type":"print","value":"1155-5645"},{"type":"electronic","value":"1460-9592"}],"subject":[],"published":{"date-parts":[[2022,6,3]]},"assertion":[{"value":"2020-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}