Prospective Insights into Pediatric Neurosurgery: Transforming Care Through Adverse Event Analysis

Introduction: Recent advancements in pediatric neurosurgery have significantly enhanced patient care and monitoring. Despite these improvements, the complexity of these procedures continues to pose a high risk of adverse events (AEs). Current literature lacks comprehensive AE data, underscoring a critical gap in research. This study addresses this void by utilizing a prospectively collected database from a premier neurosurgical tertiary center, aiming to develop critical care guidelines, optimize resource allocation, and foster interdisciplinary collaborations to mitigate AEs.

Methods: This prospective study enrolled pediatric patients undergoing neurosurgery between January 2020 and December 2023. AEs were defined as any undesirable outcomes occurring within 30 days post-operation, with each event peer-reviewed at discharge.

Results: Among the 1,008 patients studied, ranging from newborns to 17 years (mean age 10.5 years), 82.5% underwent elective procedures and 14.4% emergency procedures. The overall incidence of surgery-related AEs was 9.2%, with 5.2% requiring revision surgery. Cranial pathologies, accounting for 37.5% of interventions, were the most common, with wound infections and cerebrospinal fluid (CSF) leaks being most prevalent. The mortality rate was notably low at 0.4%, primarily attributable to severe underlying conditions like medulloblastoma progression and severe traumatic brain injuries. Non-surgery-related AEs occurred at a rate of 2.4%.

Conclusion : The study highlights a significantly low incidence of AEs in pediatric neurosurgery, demonstrating the effectiveness of systematic AE documentation and the necessity of continuous data monitoring. The findings not only contribute to better patient education but also influence quality-based healthcare reforms, emphasizing the need for prospective AE tracking to enhance patient safety and care standards.