Identifying risk factors for early 30-day postoperative complications following pediatric scoliosis surgery: a systematic review and meta-analysis

BACKGROUND: Early (within 30 days) postoperative complications following pediatric scoliosis surgery continue to be of clinical importance; however, reported risk factors demonstrate inconsistency across various studies. We conducted a systematic review and meta-analysis to quantify patient- and procedure-related predictors of 30-day postoperative outcomes complications. METHODS: statistic. RESULTS: = 0%), with no observed heterogeneity across studies. In contrast, multiple medical and patient-related risk factors including cardiopulmonary, hematologic and metabolic comorbidities were not significantly associated with postoperative morbidity, although point estimates suggested a directionally elevated risk and were characterized by wide confidence intervals. Male sex and neuromuscular disorders were also not associated with a significant increase in risk. CONCLUSIONS: Among the evaluated factors, complex surgical techniques involving osteotomy and pelvic fixation were the most consistent predictors of early postoperative complications within the contemporary literature. Preoperative patient comorbidities showed variable, generally non-significant associations, underscoring the need for standardized risk definitions and prospective multicenter studies to better predict outcomes in the early postoperative period.