ABSTRACT
PURPOSE: We sought to identify the national incidence of acute kidney injury (AKI) associated with pediatric posterior spinal fusion (PSF) surgery for scoliosis, and to determine factors that increase risk. METHODS: The 1998-2014 National Inpatient Sample (NIS), a large United States hospital discharge database, was queried for discharges aged 0-17 years with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for scoliosis undergoing PSF for the outcome of AKI. Discharges were divided into those with AKI and unaffected. We fit adjusted logistic regression models to yield point estimates, odds ratios, 95% confidence intervals, and p values for the weighted, national population sample with postulated risk factors. The fit of the multivariable regression model was tested using the Hosmer-Lemeshow test, and collinearity using the variance inflation factor. RESULTS: The NIS contained 103,270 weighted discharges meeting inclusion criteria. AKI incidence was 0.1%. Multivariable logistic regression model showed significantly increased odds ratios with thrombocytopenia, rhabdomyolysis, chronic kidney disease, abnormal coagulation, and male sex. AKI increased both hospital stay and cost by threefold compared to unaffected children. CONCLUSION: This study suggests that AKI after pediatric PSF is rare. It is associated with abnormal coagulation, chronic kidney disease, and rhabdomyolysis, but not with the number of vertebral levels fused. Female sex appears to be protective. The retrospective nature of study and reliance on ICD-9-CM codes may under-represent the incidence of AKI in pediatric PSF patients.
Subject(s)
Acute Kidney Injury/epidemiology , Postoperative Complications/epidemiology , Scoliosis/surgery , Spinal Fusion/methods , Acute Kidney Injury/etiology , Adolescent , Blood Coagulation Disorders , Child , Cross-Sectional Studies , Female , Humans , Incidence , International Classification of Diseases , Male , Postoperative Complications/etiology , Retrospective Studies , Rhabdomyolysis , Risk Factors , Sex Factors , ThrombocytopeniaSubject(s)
Craniofacial Abnormalities/surgery , Intubation, Intratracheal/methods , Orthognathic Surgery/methods , Adolescent , Anesthesia, General/methods , Catheters , Child, Preschool , Female , Humans , Intubation, Intratracheal/instrumentation , Laryngoscopy/instrumentation , Laryngoscopy/methods , Male , NoseABSTRACT
Boron-10 enriched boric acid, H310BO3, was converted to the corresponding sodium borohydride, Na10BH4, in essentially quantitative yields, by using slightly modified literature methods involving the formation of butyl borate, (n-OBu)310B, first and then reacting it with NaH in mineral oil. The oxidation reaction of Na10BH4 with I2 in diglyme and subsequent addition/purification in dioxane gave Na[10B3H8]0.3(C4H8O2) that reacted further with NiCl2 in either anhydrous benzene or heavy mineral oil at 110 degrees C to produce the corresponding 10B5H9 as the first isolated 10B-enriched liquid boron hydride in a laboratory environment. Treatment of this 10B5H9 with NaH or t-BuLi in 2:1 molar ratio underwent a cage expansion reaction to produce the [M]10B9H14 that undergoes a redox reaction in situ with anhydrous NiCl2 in n-hexane to yield the corresponding fused cage anti-10B18H22 as the only solid borane product in 42% yield, thus establishing new synthetic routes for the preparation of 10B-enriched polyhedral boranes.
