{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:40:26Z","timestamp":1777448426849,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T00:00:00Z","timestamp":1684540800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unplanned returns to the operating room (uROR) are associated with worse outcomes including increased complications and length of stay (LOS) in adults. However, the incidence and predictors of uROR for pediatric trauma patients (PTPs) are unknown. This study aimed to identify predictors of uROR for PTPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2017-2019 Trauma Quality Improvement Program database was queried for PTPs 1-16\u00a0years-old to compare patients with uROR to those without uROR. Multivariable logistic regression analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 44\u00a0711 PTPs identified, 299 (.7%) underwent uROR. Pediatric trauma patients requiring uROR were older (14 vs 8\u00a0years old, P &lt; .001), had a higher rate and associated risk of mortality (8.7% vs 1.4%, P &lt; .001) (OR 6.67, CI 4.43-10.05, P &lt; .001) as well as increased complications including surgical infection (16.4% vs .2%, P &lt; .001) and compartment syndrome (4.7% vs .1%, P &lt; .001). Patients undergoing uROR had increased LOS (18 vs 2\u00a0days, P &lt; .001) and intensive care unit LOS (9 vs 3\u00a0days, P &lt; .001). Independent associated risk factors for uROR included rectal injury (OR 4.54, CI 2.28-9.04, P &lt; .001), brain injury (OR 3.68, CI 2.71-5.00, P &lt; .001), and gunshot wounds (OR 2.55, CI 1.83-3.56, P &lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The incidence of uROR was &lt;1% for PTPs. However, patients requiring uROR had increased LOS and associated risk of death compared to those without uROR. Predictors of uROR included gunshot wounds and injuries to the rectum and brain. Patients with these risk factors should be counseled with efforts made to improve care for these high-risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348231175140","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T03:57:02Z","timestamp":1684555022000},"page":"4072-4076","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Unplanned Returns to the Operating Room in Pediatric Trauma Patients"],"prefix":"10.1177","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3812-9032","authenticated-orcid":false,"given":"Jessica","family":"Sea","sequence":"first","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Areg","family":"Grigorian","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lourdes","family":"Swentek","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Chin","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura F.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Orange County, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yigit","family":"Guner","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffry","family":"Nahmias","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"bibr1-00031348231175140","volume-title":"Web-Based Injury Statistics Query and Reporting System (WISQARS)","author":"Centers for Disease Control and 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