Work

Comparative analysis of two methods for assessing complications in pediatric surgery for extravisceral neck tumors: a cohort study

Year: 2025

Type: article

Abstract: BACKGROUND: The lack of a unified approach to assessing postoperative complications in children with extravisceral neck tumors hinders risk stratification and selection of the optimal management strategy. AIM: The study aimed to compare the prognostic accuracy of the Clavien–Dindo classification (CDC) and Comprehensive Complication Index (CCI) for predicting prolonged hospitalization (8 days) and adverse oncologic outcomes. METHODS: Data from 153 patients (≤17 years) who underwent extravisceral neck tumor resection at the Dmitry Rogachev National Medical Research Center between 2012 and 2022 were analyzed. Postoperative complications were graded using CDC and CCI. Univariable and multivariable logistic regression, Cox regression, survival analysis, and ROC analysis were performed, and model comparison techniques were applied. RESULTS: Of the operated children, the median age was 2.9 years (1.2–8.3; 0.1–17.9), and 49% were boys. Severe complications (CDC ≥ IIIa) were conventionally reported in 13.1% of patients (20/153), whereas minor complications were determined in 24.8% (38/153). The median CCI for the entire cohort was 0 (0–20.9) and 21.8 (8.7–32.4) among those with recorded complications. Using CCI, 22.2% (34/153) of patients were identified to have severe complications (CCI ≥26.2), versus 13.1% (20/153) using CDC ≥ IIIa. Prognostic models using either CCI or CDC showed comparable discrimination (AUC 0.84), sensitivity of 62.7%–68.7%, and specificity of 80.2%–83.7%. The model including CCI retained advantages by information criteria, whereas the CDC-based model may be clinically useful when complication classification needs to be considered. Complications were not associated with local recurrence or with overall survival. CONCLUSION: Combined CCI and CDC enable more precise stratification by complication severity and, when incorporated into a prognostic model, accurately predicts prolonged hospitalization in approximately 8 of 10 patients.

Source: Kazan medical journal

DOI: 10.17816/kmj688295

Authors: Georgy A. Polev, Nikolai S. Grachev, Raisa S. Oganesyan, Ekaterina I. Iaremenko

Institution: Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology

Topic: Cardiac, Anesthesia and Surgical Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $93

OpenAlex ID: W4416552883

FWCI:

Cites: 40

Cited by:

Related to: