{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:51:20Z","timestamp":1747187480264,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,25]],"date-time":"2023-12-25T00:00:00Z","timestamp":1703462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neonates have a high incidence of respiratory and cardiac perioperative events. Disease severity and indications for surgical intervention often dovetail with an overall complex clinical course and predispose these infants to adverse long\u2010term neurodevelopmental outcomes and increased length of stay. Our aims were to describe severe and nonsevere early postoperative complications to establish a baseline of care outcomes and to identify subgroups of surgical neonates and procedures for future prospective studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic health record data were examined retrospectively for a cohort of patients who had general anesthesia from January 26, 2015 to August 31, 2018. Inclusion criteria were full\u2010term infants with postmenstrual age less than 44\u2009weeks or premature infants less than 60\u2009weeks postmenstrual age undergoing nonimaging, noncardiac surgery. Severe postoperative complications were defined as mortality, reintubation, positive blood culture, and surgical site infection. Nonsevere early postoperative outcomes were defined as hypoglycemia, hyperglycemia, hypothermia, hyperthermia, and readmission within 30\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 2569 procedures were performed in 1842 neonates of which 10.9% were emergency surgeries. There were 120 postoperative severe complications and 965 nonsevere postoperative outcomes. Overall, 30\u2010day mortality was 1.8% for the first procedure performed, with higher mortality seen on subgroup analysis for patients who underwent exploratory laparotomy (10.3%) and congenital lung lesion resection (4.9%). Postoperative areas for improvement included hyperglycemia (13.9%) and hypothermia (7.9%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The mortality rate in our study was comparable to other studies of neonatal surgery despite a high rate of emergency surgery and a high prevalence of prematurity in our cohort. The early outcomes data identified areas for improvement, including prevention of postoperative glucose and temperature derangements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neonates in this cohort were at risk for severe and nonsevere adverse postoperative outcomes. Future studies are suggested to improve mortality and adverse event rates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14827","type":"journal-article","created":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T07:19:16Z","timestamp":1703575156000},"page":"354-365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical neonates: A retrospective review of procedures and postoperative outcomes at a quaternary children's hospital"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2930-138X","authenticated-orcid":false,"given":"Olivia","family":"Nelson","sequence":"first","affiliation":[{"name":"Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Anesthesiology and Critical Care Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie E.","family":"Rintoul","sequence":"additional","affiliation":[{"name":"Division of Neonatology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan M.","family":"Tan","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Anesthesiology and Critical Care Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Anesthesiology Critical Care Medicine Children's Hospital of Los Angeles and the Keck School of Medicine at the University of Southern California, and the Spatial Science Institute at the University of Southern California  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8871-2579","authenticated-orcid":false,"given":"Allan F.","family":"Simpao","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Anesthesiology and Critical Care Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Chuo","sequence":"additional","affiliation":[{"name":"Division of Neonatology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly L.","family":"Hedrick","sequence":"additional","affiliation":[{"name":"Division of Pediatric General, Thoracic and Fetal Surgery Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Surgery Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4544-8536","authenticated-orcid":false,"given":"Melissa S.","family":"Duran","sequence":"additional","affiliation":[{"name":"Division of Neonatology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spandana","family":"Makeneni","sequence":"additional","affiliation":[{"name":"Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Devine","sequence":"additional","affiliation":[{"name":"Department of Data and Analytics, Information Services Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lusha","family":"Cao","sequence":"additional","affiliation":[{"name":"Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5012-8035","authenticated-orcid":false,"given":"Paul A.","family":"Stricker","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Anesthesiology and Critical Care Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,25]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.02.016"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001059"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30116-9"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2019.05.017"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2016.08.008"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.01.033"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003386"},{"key":"e_1_2_15_10_1","unstructured":"Clinical Classifications Software (CCS).Refined for ICD\u201010 PCS Procedures Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project.2019. Accessed September 25 2020.https:\/\/www.hcup\u2010us.ahrq.gov\/toolssoftware\/ccsr\/prccsr.jsp"},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2013","author":"R Core Team","key":"e_1_2_15_11_1"},{"key":"e_1_2_15_12_1","unstructured":"Children's Hospital of Philadelphia Clinical Pathways.2012.https:\/\/www.chop.edu\/clinical\u2010pathway\/perioperative\u2010care\u2010newborns\u2010infants\u2010clinical\u2010pathway"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13047"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.07.026"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001343"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004043"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004433"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13981"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.1032"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001646"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14827","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,3]],"date-time":"2024-03-03T06:25:41Z","timestamp":1709447141000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,25]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/pan.14827"],"URL":"https:\/\/doi.org\/10.1111\/pan.14827","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"type":"print","value":"1155-5645"},{"type":"electronic","value":"1460-9592"}],"subject":[],"published":{"date-parts":[[2023,12,25]]},"assertion":[{"value":"2023-04-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}