• Azeem Tariq Malik, Jeffery Kim, Elizabeth Yu, and Safdar N Khan.
• Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
• World Neurosurg. 2019 Jan 1; 121: e344-e350.

ObjectiveTo assess the impact of fixation to pelvis on 30-day outcomes after posterior spinal fusions in pediatric spine deformities.MethodsThe 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program pediatric database was queried using Current Procedural Terminology codes for patients undergoing posterior spinal fusions (22800, 22802, and 22804). Patients undergoing concurrent anterior fusion/combined fusion and anterior-only fusions were removed from the study. Patients undergoing additional fixation to pelvis were identified by code 22848.ResultsOf a total of 13,398 patients, 1092 (8.2%) patients underwent a fixation to the pelvis. After adjustment for differences in baseline characteristics, patients undergoing fixation to pelvis had a longer length of stay (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.04-1.48]), greater odds of any 30-day complication (OR 1.26; CI 1.03-1.55), pneumonia (OR 1.85; CI 1.26-2.70), renal insufficiency (OR 6.87; CI 2.02-23.40), acute renal failure (OR 14.23; CI 2.36-84.51), urinary tract infection (OR 1.99; CI 1.23-3.23), cardiac arrest (OR 2.98; CI 1.10-8.06), sepsis (OR 2.25; CI 1.35-3.74), bleeding (OR 1.51; CI 1.25-1.82), 30-day readmissions (OR 1.39; CI 1.07-1.81), and 30-day reoperations (OR 1.37; CI 1.06-1.76).ConclusionsIn contrast to adult spinal deformity literature, pediatric patients undergoing a fixation to pelvis are at a greater risk of experiencing adverse outcomes within 30 days of surgery. Providers should use these data for preoperative counseling and/or risk-stratification to improve quality-of-care in the acute postoperative period in these patients.Copyright © 2018 Elsevier Inc. All rights reserved.

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