Table 5.
Univariate and multivariate analysis of predictors of morbidity
| Univariate | Multivariate | ||||
|---|---|---|---|---|---|
|
|
|
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| Morbidity (n=5482) | No morbidity (n=16,282) | P | OR (95% CI) | P | |
| Demographics, n (%) | |||||
| Age (years), mean (SD) | 13.9 (2.5) | 13.5 (3.1) | <0.001 | 1.051 (1.034–1.069) | <0.001 |
| African−American race | 1966 (19.1) | 769 (16.0) | <0.001 | 1.193 (1.068–1.333) | 0.002 |
| Hispanic ethnicity | 1180 (11.0) | 476 (9.6) | 0.008 | 1.401 (1.206–1.628) | <0.001 |
| Female gender | 7826 (68.2) | 3994 (72.9) | <0.001 | 0.959 (0.870–1.058) | 0.403 |
| Comorbidities, n (%) | |||||
| Obese | 1638 (15.1) | 834 (15.8) | 0.264 | ||
| Pulmonary comorbidity | 2132 (18.6) | 732 (13.4) | <0.001 | 1.032 (0.906–1.177) | 0.634 |
| Cardiac comorbidity | 1066 (9.3) | 413 (7.5) | <0.001 | 1.113 (0.950–1.305) | 0.184 |
| Esophageal/GI disease | 1366 (11.9) | 359 (6.5) | <0.001 | 1.247 (1.045–1.487) | 0.014 |
| Developmental delay | 2794 (24.4) | 790 (14.4) | <0.001 | 1.291 (1.113–1.498) | 0.001 |
| Seizure disorder | 1343 (11.7) | 268 (4.9) | <0.001 | 1.384 (1.111–1.723) | 0.004 |
| Cerebral palsy | 1338 (11.7) | 263 (4.8) | <0.001 | 1.078 (0.859–1.353) | 0.519 |
| Structural CNS abnormality | 1621 (14.1) | 630 (11.5) | <0.001 | 0.798 (0.695–0.917) | 0.001 |
| Neuromuscular disorder | 2894 (25.2) | 846 (15.4) | <0.001 | 1.310 (1.150–1.492) | <0.001 |
| Preoperative steroid use | 141 (1.2) | 41 (0.7) | 0.004 | 1.294 (0.829–2.020) | 0.256 |
| Nutritional support | 1088 (9.5) | 212 (3.9) | <0.001 | 1.218 (0.958–1.548) | 0.107 |
| Hematologic disorder | 249 (2.2) | 70 (1.3) | <0.001 | 1.233 (0.885–1.718) | 0.216 |
| Congenital malformation | 3610 (31.5) | 1553 (28.3) | <0.001 | 0.863 (0.779–0.956) | 0.005 |
| Childhood malignancy | 100 (0.9) | 71 (1.3) | 0.010 | 0.579 (0.392–0.855) | 0.006 |
| ASA-class ≥3 | 3847 (33.6) | 1316 (24.0) | <0.001 | 0.904 (0.800–1.022) | 0.106 |
| Lab values, mean (SD) | |||||
| White cell count | 6.9 (2.4) | 6.9 (2.2) | 0.423 | 0.993 (0.975–1.011) | 0.442 |
| Hematocrit | 39.9 (4.4) | 39.9 (4.4) | 0.987 | 0.979 (0.968–0.991) | 0.001 |
| INR | 1.1 (0.1) | 1.1 (0.1) | 0.228 | ||
| Procedural factors | |||||
| Computer assistance | |||||
| With CAS | 269 (75.6a) | 87 | 0.001 | 0.992 (0.738–1.333) | 0.955 |
| Without CAS | 11,199 (67.5b) | 15,947 | |||
| Operative time | 304 (111) | 247 (94) | <0.001 | 1.005 (1.005–1.006) | <0.001 |
| LOS | 5.6 (5.8) | 4.9 (5.7) | <0.001 | 0.999 (0.991–1.007) | 0.776 |
| Total RVUs | 62.9 (27.4) | 54.7 (24.0) | <0.001 | 1.009 (1.007–1.011) | <0.001 |
aPercent of patients with CAS who experienced morbidity; bPercent of patients without CAS who experienced morbidity; #Fisher’s exact test. Bold values indicate significance (P<0.05). Pulmonary comorbidities include ventilator dependence, asthma, chronic lung disease, chronic oxygen support, tracheostomy, or structural pulmonary or airway abnormalities. Cardiac comorbidities include previous cardiac surgery and cardiac risk factors. ASA - American Society of Anesthesiologists; RVUs - Relative value units; CAS - Computer assisted surgery; GI - Gastric/intestinal; CNS - Central nervous system; SD - Standard deviation; INR - International normalized ratio; OR - Odds ratio; CI - Confidence interval; LOS - Length of stay