# Developmental delay increases risk for complications within 30 days of pediatric spinal fusion surgery

## TL;DR

Children with developmental delays face higher risks of complications after spinal fusion surgery, according to a study using national surgical data.

## Contribution

This study identifies developmental delay as an independent risk factor for postoperative complications in pediatric spinal fusion patients.

## Key findings

- Developmental delay was associated with higher rates of surgical and medical complications.
- Patients with developmental delay had a significantly increased risk of ICU stay and death.
- The study provides evidence to improve preoperative risk assessment for pediatric spinal fusion.

## Abstract

The aim of this study was to investigate whether developmental delay is a risk factor for postoperative complications following pediatric spinal fusion.

The American College of Surgeons National Surgical Quality Improvement Program Pediatric database was queried to retrospectively identify patients who had undergone spinal fusions between 2016 and 2021. The study population was divided into two distinct groups 1) Patients with developmental delay 2) who have no delay. T-tests for continuous variables and chi-square tests for categorical variables were used to identify differences in perioperative characteristics between the two groups. Multivariable logistic regression analysis assessed the effect of preoperative developmental delay on post-operative surgical outcomes.

A total of 32,621 pediatric spinal fusion patients were identified, of which 7,637 had developmental delay and 24,984 had no delay. The developmental delay group had a higher rate of surgical complications and medical complications (5.38% vs 1.41%, p < 0.001). Developmental delay independently increased the risk for medical complications (OR: 1.099, 95% CI: (1.009–1.978), surgical complications (OR: 1.4833, 95% CI (1.197–1.838), extended hospital LOS (OR: 1.250, 95% CI (1.028–1.518), intensive care unit stay (OR: 1.333, 95% CI (1.227–1.446), and death (OR: 9.638, 95% CI: 2.150–68.700) following a multivariate logistic regression analysis.

Patients with developmental delay undergoing pediatric spinal fusion had an increased risk for surgical complications. The findings of this study serve as a valuable resource in aiding surgeons in preoperative risk assessment and in facilitating comprehensive discussions with patients and their caregivers.