An Assessment of 30-Day Complications in Primary XXXX Repair: A Review of the 2012 ACS NSQIP Pediatric.

@entity1 @entity73 @entity26 @entity1576 @entity2419
OBJECTIVE:     This study uses the American College of Surgeons Pediatric National Surgical Quality Improvement Program (ACS NSQIP Pediatric), a multicenter database, to identify risk factors for complications after @entity2419 repair. DESIGN:     @entity1 undergoing Current Procedural Terminology (CPT) codes 42200 and 42205 were extracted from the 2012 ACS NSQIP Pediatric. @entity1 older than 36 months or those who had undergone an additional surgery that altered the risk were excluded. Outcome variables were combined to create a complication variable. Fisher's exact, Pearson chi-square, and Wilcoxon rank-sum tests were used for analysis. RESULTS:     Eligibility criteria were met by 751 @entity1 . Of these, 192 (25.6%) had unilateral clefts, 146 (19.4%) bilateral, and 413 (55.0%) were unspecified. The average age at time of surgery for those without and with complications was 421.1    184.8 and 433.6    168.0 days, respectively (P = .76). Of the 21 (2.8%) @entity1 with complications, @entity1576 were the most common. Risk factors associated with complications included American Society of Anesthesiologists classification of 3 (P = .003), nutritional support (P = .013), esophageal/gastric/intestinal disease (P = .016), @entity26 support (P = .003), structural pulmonary/airway abnormality (P = .011), and @entity73 (P = .009). @entity1 undergoing concurrent laryngoscopy (P = .048) or other surgeries (P = .047) were also found to be associated with increased complications. The 30-day fistula rate was 0.5%, and the readmission rate was 1.9%. CONCLUSION:     Perioperative complications for primary palatoplasty were 2.8% according to the ACS NSQIP Pediatric. Preoperative @entity1 -related factors as well as concurrent surgeries may affect 30-day complication rates. These results help target those at greater risk for complications and allow for appropriate interventions to mitigate risks.
