Correspondence  |   January 2020
Improving Pediatric Risk Stratification: Comment
Author Notes
  • Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania (S.E.S.B.). sydneyesbrown@gmail.com
  • (Accepted for publication October 3, 2019.)
    (Accepted for publication October 3, 2019.)×
Article Information
Correspondence
Correspondence   |   January 2020
Improving Pediatric Risk Stratification: Comment
Anesthesiology 1 2020, Vol.132, 212-213. doi:https://doi.org/10.1097/ALN.0000000000003034
Anesthesiology 1 2020, Vol.132, 212-213. doi:https://doi.org/10.1097/ALN.0000000000003034
It was with great interest that we read your recent article, “Pediatric Risk Stratification Is Improved by Integrating Both Patient Comorbidities and Intrinsic Surgical Risk,”1  as this model could be useful in prognostication of negative outcomes after surgery, quality improvement, and risk adjustment. This methodologically rigorous analysis empirically derived procedural risk groupings, and added these groupings into a predictive model for 30-day postoperative mortality after common pediatric surgical procedures utilizing The American College of Surgeons National Surgical Quality Improvement Program Pediatric Surgical Risk Calculator dataset. The model also contained five patient variables (American Society of Anesthesiologists Physical Status, weight less than 5 kg, sepsis, preoperative mechanical ventilation, and preoperative vasopressors) to adjust for patient comorbidity. The inclusion of procedural risk groupings improved model discrimination significantly, and groupings were said to represent the “intrinsic surgical risk” of the procedures analyzed.