{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:31:36Z","timestamp":1784248296643,"version":"3.55.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T00:00:00Z","timestamp":1515024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to identify risk factors for adverse perioperative events (APEs) after cleft palatoplasty to develop an individualized risk assessment tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary institutional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>\n                      Patients younger than 2 years with cleft palate.\n                      <jats:italic>Interventions:<\/jats:italic>\n                      Primary Furlow palatoplasty between 2008 and 2011.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s):<\/jats:title>\n                    <jats:p>Adverse perioperative event, defined as laryngo- or bronchospasm, accidental extubation, reintubation, obstruction, hypoxia, or unplanned intensive care unit admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Three hundred patients averaging 12.3 months old were included. Cleft distribution included submucous, 1%; Veau 1, 17.3%; Veau 2, 38.3%; Veau 3, 30.3%; and Veau 4, 13.0%. Pierre Robin (n = 43) was the most prevalent syndrome\/anomaly. Eighty-three percent of patients received reversal of neuromuscular blockade, and total morphine equivalent narcotic dose averaged 0.19 mg\/kg. Sixty-nine patients (23.0%) had an APE, most commonly hypoventilation (10%) and airway obstruction (8%). Other APEs included reintubation (4.7%) and laryngobronchospasm (3.3%). APE was associated with multiple intubation attempts (odds ratio [OR] = 6.6,\n                      <jats:italic>P<\/jats:italic>\n                      = .001), structural or functional airway anomaly (OR = 4.5,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), operation &gt;160 minutes (OR = 2.2,\n                      <jats:italic>P<\/jats:italic>\n                      = .04), narcotic dose &gt;0.3 mg\/kg (OR = 2.3,\n                      <jats:italic>P<\/jats:italic>\n                      = .03), inexperienced provider (OR = 2.1,\n                      <jats:italic>P<\/jats:italic>\n                      = .02), and no paralytic reversal administration (OR = 2.0,\n                      <jats:italic>P<\/jats:italic>\n                      = .049); weight between 9 and 13 kg was protective (OR = 0.5,\n                      <jats:italic>P<\/jats:italic>\n                      = .04). Patients were risk-stratified according to individual profiles as low, average, high, or extreme risk (APE 2.5%-91.7%) with excellent risk discrimination (C-statistic = 0.79).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>APE incidence was 23.0% after palatoplasty, with a 37-fold higher incidence in extreme-risk patients. Individualized risk assessment tools may enhance perioperative clinical decision making to mitigate complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665617744065","type":"journal-article","created":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T18:21:28Z","timestamp":1515090088000},"page":"574-581","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-5886","authenticated-orcid":false,"given":"Marten N.","family":"Basta","sequence":"first","affiliation":[{"name":"Brown University, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Fiadjoe","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert S.","family":"Woo","sequence":"additional","affiliation":[{"name":"Brown University, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth N.","family":"Peeples","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oksana A.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,1,4]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2012.01.013"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2002_039_0145_aofpao_2.0.co_2"},{"issue":"5","key":"e_1_3_2_4_1","first-page":"413","article-title":"Can we predict a difficult intubation in cleft lip\/palate patients?","volume":"40","author":"Arteau-Gauthier I","year":"2011","unstructured":"Arteau-Gauthier I, Leclerc JE, Godbout A. 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