295 Risk Factors Associated With Postoperative Infection following Pediatric Tethered Cord Release: An Analysis of 2012 – 2021 NSQIP-Pediatric Database

INTRODUCTION: Surgical site infections (SSI) are a common postoperative complication following tethered spinal cord release. METHODS: A retrospective cohort analysis was performed utilizing data from the 2012–2021 ACS NSQIP-Pediatric database. Patients who underwent laminectomy with tethered spinal cord release were identified based on CPT and ICD-9/10 codes. Patients were grouped into cohorts according to the occurrence of POI. Patient demographics, comorbidities, adverse events (AE), and clinical outcomes were evaluated. Predictors of POI were determined using multivariate logistic regression analysis. RESULTS: Of the 10,210 identified patients, 360 experienced postoperative POI. Patients with POI were younger (No POI (NPOI): 5.82±4.88 years vs. POI: 4.64±4.47,p<0.001), had greater ASA scores (NPOI ASA 3: 31.0% vs POI ASA 3: 45.0%,p<0.001), and experienced more overall AEs (NPOI: No AE: 96% vs. POI: No AE: 65.6%,p<0.001). Patients with POI also experienced longer lengths of stay (NPOI: 2.62±2.76 days vs. POI: 3.87±3.88 days,p<0.001) and greater rates of unplanned readmissions (NPOI: 3.9% vs. POI: 54.2%,p<0.001) and reoperations (NPOI: 1.7% vs. POI: 40.3%,p<0.001). On multivariate analysis, independent associations of POI included younger age, ASA classification 3, structural CNS abnormality, impaired cognitive status, and longer operative time. CONCLUSIONS: Our study identifies patient- and surgical-level factors associated with SSI following surgical release of tethered spinal cord among pediatric patients. Further investigations are necessary to better understand the factors that contribute to postoperative infections and help develop effective strategies to reduce infection rates to improve patient outcomes.