• Nathalie Bourdaud, Jean-Michel Devys, Jocelyne Bientz, Corinne Lejus, Anne Hebrard, Olivier Tirel, Damien Lecoutre, Nada Sabourdin, Yves Nivoche, Catherine Baujard, Lydia Nikasinovic, and Gilles A Orliaguet.
• Department of Anesthesiology and Critical Care Medicine, Centre Hospitalier Universitaire Necker - Enfants Malades, AP-HP, University Paris Descartes, Paris, France.
• Paediatr Anaesth. 2014 Sep 1; 24 (9): 945-52.

BackgroundFew data are available in the literature on risk factors for postoperative vomiting (POV) in children.ObjectiveThe aim of the study was to establish independent risk factors for POV and to construct a pediatric specific risk score to predict POV in children.MethodsCharacteristics of 2392 children operated under general anesthesia were recorded. The dataset was randomly split into an evaluation set (n = 1761), analyzed with a multivariate analysis including logistic regression and backward stepwise procedure, and a validation set (n = 450), used to confirm the accuracy of prediction using the area under the receiver operating characteristic curve (ROCAUC ), to optimize sensitivity and specificity.ResultsThe overall incidence of POV was 24.1%. Five independent risk factors were identified: stratified age (>3 and <6 or >13 years: adjusted OR 2.46 [95% CI 1.75-3.45]; ≥6 and ≤13 years: aOR 3.09 [95% CI 2.23-4.29]), duration of anesthesia (aOR 1.44 [95% IC 1.06-1.96]), surgery at risk (aOR 2.13 [95% IC 1.49-3.06]), predisposition to POV (aOR 1.81 [95% CI 1.43-2.31]), and multiple opioids doses (aOR 2.76 [95% CI 2.06-3.70], P < 0.001). A simplified score was created, ranging from 0 to 6 points. Respective incidences of POV were 5%, 6%, 13%, 21%, 36%, 48%, and 52% when the risk score ranged from 0 to 6. The model yielded a ROCAUC of 0.73 [95% CI 0.67-0.78] when applied to the validation dataset.ConclusionsIndependent risk factors for POV were identified and used to create a new score to predict which children are at high risk of POV.© 2014 John Wiley & Sons Ltd.

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