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Erschienen in: Child's Nervous System 1/2021

09.06.2020 | Original Article

Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation

verfasst von: Aladine A. Elsamadicy, Andrew B. Koo, Wyatt B. David, Adam J. Kundishora, Christopher S. Hong, Margot Sarkozy, Kristopher T. Kahle, Michael DiLuna

Erschienen in: Child's Nervous System | Ausgabe 1/2021

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Abstract

Purpose

For young children and adolescents with Chiari malformation type I (CM-I), the determinants of extended length of hospital stay (LOS) after neurosurgical suboccipital decompression are obscure. Here, we investigate the impact of patient- and hospital-level risk factors on extended LOS following surgical decompression for CM-I in young children to adolescents.

Methods

The Kids’ Inpatient Database year 2012 was queried. Pediatric CM-I patients (6–18 years) undergoing surgical decompression were identified. Weighted patient demographics, comorbidities, complications, LOS, disposition, and total cost were recorded. A multivariate logistic regression was used to determine the odds ratio for risk-adjusted LOS. The primary outcome was the degree patient comorbidities or post-operative complications correlated with extended LOS.

Results

A total of 1592 pediatric CM-I patients were identified for which 328 (20.6%) patients had extended LOS (normal LOS, 1264; extended LOS, 328). Age, gender, race, median household income quartile, and healthcare coverage distributions were similar between the two cohorts. Patients with extended LOS had significantly greater admission comorbidities including headache symptoms, nausea and vomiting, obstructive hydrocephalus, lack of coordination, deficiency anemias, and fluid and electrolyte disorders. On multivariate logistic regression, several risk factors were associated with extended LOS, including headache symptoms, obstructive hydrocephalus, and fluid and electrolyte disorders.

Conclusions

Our study using the Kids’ Inpatient Database demonstrates that presenting symptoms and signs, including headaches and obstructive hydrocephalus, respectively, are significantly associated with extended LOS following decompression for pediatric CM-I.
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Metadaten
Titel
Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation
verfasst von
Aladine A. Elsamadicy
Andrew B. Koo
Wyatt B. David
Adam J. Kundishora
Christopher S. Hong
Margot Sarkozy
Kristopher T. Kahle
Michael DiLuna
Publikationsdatum
09.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 1/2021
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04688-2

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