Abstract：
This study examined the risk factors for short-term outcomes, focusing particularly on the associations among molecular subgroups. The analysis focused on the data of pediatric patients with medulloblastoma between 2013 and 2023, as well as operative complications, length of stay from surgery to adjuvant treatment, 30-day unplanned reoperation, unplanned readmission, and mortality. 148 patients were included. Patients with the SHH TP53-wildtype exhibited a lower incidence of complications (45.2% vs. 66.0%, odds ratio [OR] 0.358, 95% confidence interval [CI] 0.160 - 0.802). Female sex (0.437, 0.207 - 0.919) was identified as an independent protective factor for complications, and brainstem involvement (1.900, 1.297 - 2.784) was identified as a risk factor. Surgical time was associated with an increased risk of complications (1.004, 1.001 - 1.008), duration of hospitalization (1.006, 1.003 - 1.010), and reoperation (1.003, 1.001 - 1.006). Age was found to be a predictor of improved outcomes, as each additional year was associated with a 14.1% decrease in the likelihood of experiencing a prolonged length of stay (0.859, 0.772 - 0.956). Patients without metastasis exhibited a reduced risk of reoperation (0.322, 0.133 - 0.784) and readmission (0.208, 0.074 - 0.581). There is a significant degree of variability in the occurrence of operative complications in pediatric patients with medulloblastoma. SHH TP53-wildtype medulloblastoma is commonly correlated with a decreased incidence of complications. The short-term outcomes of patients are influenced by various unmodifiable endogenous factors. These findings could enhance the knowledge of onconeurosurgeons and alleviate the challenges associated with patient/parent education through personalized risk communication. However, the importance of a dedicated center with expertise surgical team and experienced neurosurgeon in improving neurosurgical outcomes appears self-evident.
摘要：
这项研究检查了短期结果的风险因素，特别关注分子亚组之间的关联。分析的重点是2013年至2023年之间的小儿髓母细胞瘤患者的数据，以及手术并发症，从手术到辅助治疗的住院时间，30天计划外再手术,计划外的重新接纳,和死亡率。148名患者被包括在内。SHHTP53野生型患者的并发症发生率较低（45.2％vs.66.0%,优势比[OR]0.358，95%置信区间[CI]0.160-0.802)。女性（0.437，0.207-0.919）被确定为并发症的独立保护因素，脑干受累(1.900,1.297-2.784)被确定为危险因素.手术时间与并发症风险增加相关（1.004，1.001-1.008），住院时间（1.006，1.003-1.010），并重新操作（1.003、1.001-1.006）。年龄被发现是改善结果的预测指标，因为每增加一年,住院时间延长的可能性降低14.1%(0.859,0.772-0.956).无转移患者再次手术（0.322，0.133-0.784）和再入院（0.208，0.074-0.581）的风险降低。小儿髓母细胞瘤手术并发症的发生存在显着差异。SHHTP53-野生型髓母细胞瘤通常与并发症发生率降低相关。患者的短期结局受到各种不可改变的内源性因素的影响。这些发现可以通过个性化的风险沟通来增强对肠外科医生的知识，并减轻与患者/父母教育相关的挑战。然而,由专业的手术团队和经验丰富的神经外科医生组成的专门中心在改善神经外科结局方面的重要性不言而喻.
