Validación de Escalas de Eventos Adversos en Neurocirugía Infantil

Abstract

Introduction: The current practice of neurosurgery is associated with adverse events [AE]. There is little record of these events with no systematization, sometimes normalizing it, others attributing the event to others factors than the neurosurgical team or acussing this for the AE . Scales for classification of AE in pediatric neurosurgery are scarce, and most of them only refer to craniosynostosis surgery.
Material and methods: The records of all the patients who underwent surgery at our institution from May 2020 to May 2021 were retrospectively reviewed. We used both Landriel’s (Dindo-Clavien modification) and Houkin’s scales for classification of adverse events.
Results: Seventy-two (24,8 %) events among 290 neurosurgical interventions were recognized as AE. 45 % (n = 33) in oncologic surgery, 35 % (n = 25) in hydrocephalus, 7 % (n = 5) in congenital malformations, 7 % (n = 5) in vascular lesions and 6 % (n = 4) in others. 67 % (n = 48) of elective surgeries and 33 % (n = 24) of emergency surgeries had AE. Using Houkin’s classification, 59 % (n = 43) were grade 2 and 18 % (n = 13) were grade 4. Landriel’s classification showed prevalence of grade 2B and grade 1B (44 % and 19 % respectively). Neurological complications were the most frequent type of AE (76 %), including: infections (19 %), mechanics dysfunctions (14 %), neurologic impairment (13 %) and new deficit (8 %). Mortality was 2,7 % (n = 2)
Conclusion: Landriel’s and Houkin’s scales are useful and reliable for neurosurgery pediatric patients.