Assessing pediatric frailty: Use of the surgical complication index for pediatric patients (SCIPP) score to predict adverse outcomes following thoracic surgery.

INTRODUCTION

The Surgical Complication Index for Pediatric Patients (SCIPP) score, validated for use in pediatric neurosurgery, assesses seven components of frailty for a composite score: independence in performing activities of daily living (ADLs), autonomic function, body mass index (BMI), continence, previous admissions, mobility, and polypharmacy, while a reduced SCIPP score utilizes ADLs, autonomic function, and polypharmacy components. This study aimed to understand the predictive performance of full and reduced SCIPP score in children undergoing thoracic operations.

METHODS

A single-center retrospective review of patients age 2-18 years undergoing thoracic surgery from 2020 to 2025 was conducted, excluding patients with missing components of SCIPP score. Full and reduced SCIPP scores were calculated. Operative details and postoperative outcomes with 1-month follow-up were collected. Multiple logistic regression assessed the association between SCIPP scores, complications, and length of stay (LOS).

RESULTS

We included 317 patients. SCIPP scores were 0-1 in 70.7%, 2-3 in 18.0%, and 4+ in 11.4%. Logistic regression found that for every 1-point increase in full and reduced SCIPP scores, patients were 2.19 and 3.24 times more likely to have any complication, respectively (p < 0.001). LOS increased by 26% for each point greater in full SCIPP score and 44% for reduced SCIPP score (p < 0.001).

CONCLUSION

The SCIPP score, a composite pediatric frailty index, can predict a patient's risk of complications and likelihood of increased LOS following thoracic surgery. There is a role for SCIPP score utilization, particularly the reduced score, in the preoperative setting to optimize parental counseling, risk assessment, and determination of prehabilitation needs.