{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T20:05:20Z","timestamp":1779998720803,"version":"3.53.1"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"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":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective Cohort Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the accuracy of the ACS-NSQIP Pediatric Surgical Risk Calculator in predicting postoperative complications and mortality following pediatric spinal deformity surgery. Predicted risks were compared with observed outcomes from the ACS-NSQIP Pediatric database, stratified by scoliosis etiology, fusion level, and surgical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of pediatric patients who underwent spinal deformity correction between 2012 and 2023 using the ACS-NSQIP Pediatric database. Patients were categorized as idiopathic or neuromuscular scoliosis. Predicted risks were compared with observed 30-day outcomes including mortality, surgical site infection, pneumonia, and urinary tract infection. Predictive performance was assessed using the Brier score across discrimination and calibration dimensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 58,010 patients were included (45,211 idiopathic; 12,799 neuromuscular). Overall, the calculator predicted a 2.74% complication rate vs an observed rate of 9.54% (Brier: 0.00462; 5.35% of maximum), reflecting poor discrimination and substantially underestimated absolute risk. The most frequent complications were surgical site infection (2.12%), pneumonia (0.99%), and urinary tract infection (0.64%), each demonstrating adequate individual-level discrimination and calibration. Stratified analyses showed adequate performance for idiopathic scoliosis patients undergoing 0-12 level fusions, while discrimination was poor for \u226513 level fusions. Performance was substantially worse among neuromuscular scoliosis patients across all fusion levels. Surgical approach did not meaningfully affect performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The calculator reliably predicts select individual complications but underestimates overall risk in high-complexity cases, particularly extensive fusions and neuromuscular scoliosis. Incorporating deformity-specific and surgical complexity variables may improve preoperative risk stratification and counseling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261454935","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T10:35:21Z","timestamp":1779705321000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a Pediatric Surgical Risk Calculator for Postoperative Outcomes in Spinal Deformity"],"prefix":"10.1177","author":[{"given":"Rohin","family":"Singh","sequence":"first","affiliation":[{"name":"University of Rochester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0768-9097","authenticated-orcid":false,"given":"Omar","family":"Sbaih","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Rochester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6696-8984","authenticated-orcid":false,"given":"Nithin Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Jefferson Health NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Li","sequence":"additional","affiliation":[{"name":"University of Rochester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2584-291X","authenticated-orcid":false,"given":"Tyler K.","family":"Williamson","sequence":"additional","affiliation":[{"name":"University of Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Stone","sequence":"additional","affiliation":[{"name":"University of Rochester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-4070","authenticated-orcid":false,"given":"Peter G.","family":"Passias","sequence":"additional","affiliation":[{"name":"Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0000000000000543"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10122519"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-008-1308-5"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.21037\/jss-21-10"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568220960075"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-024-00848-5"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.21.00751"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000004792"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.3171\/2020.7.PEDS20444"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.14444\/8153"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.08.542"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_543_18"},{"key":"e_1_3_6_14_2","doi-asserted-by":"crossref","unstructured":"Brier GW. 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