title: Intraoperative complications in pediatric neurosurgery: review of 1807 cases.
abstract: OBJECTIVE Minimal literature exists on the intraoperative complication rate of pediatric neurosurgical procedures with respect to both surgical and anesthesiological complications. The aim of this study, therefore, was to establish intraoperative complication rates to provide patients and parents with information on which to base their informed consent and to establish a baseline for further targeted improvement of pediatric neurosurgical care. METHODS A clinical complication registration database comprising a consecutive cohort of all pediatric neurosurgical procedures carried out in a general neurosurgical department from January 1, 2004, until July 1, 2012, was analyzed. During the study period, 1807 procedures were performed on patients below the age of 17 years. RESULTS Sixty-four intraoperative complications occurred in 62 patients (3.5% of procedures). Intraoperative mortality was 0.17% (n = 3). Seventy-eight percent of the complications (n = 50) were related to the neurosurgical procedures, whereas 22% (n = 14) were due to anesthesiology. The highest intraoperative complication rates were for cerebrovascular surgery (7.7%) and tumor surgery (7.4%). The most frequently occurring complications were cerebrovascular complications (33%). CONCLUSIONS Intraoperative complications are not exceptional during pediatric neurosurgical procedures. Awareness of these complications is the first step in preventing them.
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: van Lindert
authors.affiliation: Anesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Arts
authors.affiliation: Anesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Blok
authors.affiliation: Anesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Hendriks
authors.affiliation: Anesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Luc
authors.initials: L
authors.lastname: Tielens
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Martine
authors.initials: M
authors.lastname: van Bilsen
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Hans
authors.initials: H
authors.lastname: Delye
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D006801:Humans; D007223:Infant; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D011446:Prospective Studies
keywords: IOC = intraoperative complication; anesthesia; complication; intraoperative; neurosurgery; pediatric