Database - Incidence and Risk Factors of Perioperative Respiratory Adverse Events in Pediatric Surgical Patients: Development and Validation of a Predictive Model in Brazil

Perioperative risk is multifactorial. Depending on the interaction between the patient's clinical conditions, specific aspects of surgery, anesthesia and postoperative care. Respiratory complications are the most frequent adverse events in anesthetized children. Discussing them is essential, as they prolong length of stay after outpatient procedures, increase unplanned hospitalizations, and generate significant costs - with a major impact on the public health system. It was an observational cohort study in which children under 16 years of age undergoing noncardiac procedures were accompanied from the pre-anesthetic evaluation until 2 hours after surgery in two high complexity public teaching hospitals in Southern Brazil. Patients undergoing obstetric procedures, transplants and those who came to surgery already intubated or tracheostomized were excluded. Factors related to previous health conditions, anesthesia and surgical techniques were evaluated. The primary endpoint is a composite of respiratory complications. Logistic regression analysis was performed to identify independent predictors associated with the outcome. Other tests were used do verify the model's performance, such as - Brier score, ROC curves, Homer-Lemeshow test, calibration plot, bootstrap and Delong test.