Introduction: The effect of age on the outcomes of Vesicoureteral Reflux (VUR) surgery is not well studied. Our hypothesis is that older children are at higher risk of complications and readmissions following open ureteroneocystostomy (UNC) as they are more prone to voiding dysfunction. Our objective is to study the rates and predictors of the 30-day post-operative urinary tract infection (poUTI) and readmissions after UNC among children younger and older than the age of 3. Methods: The ACS pediatric National Surgical Quality Improvement Program (NSQIP-P) between 2012–2020 was queried for open UNC CPT codes 50780 and 50782. Only vesicoureteral reflux patients were included. Patients with severe comorbities and unknown ASA class/prematurity were excluded. Propensity score matching (PSM) was performed in a 1:1 ratio to nearest matching (> 3 years “older group” versus =3 years “younger group”). Multivariable regression analyses were performed on the matched set for poUTI and procedure-related readmission. Database limitations included the lack of information regarding the degree of VUR, prior VUR procedures, and preoperative urine culture results. All analyses were performed utilizing R 4.1.2. Results: 6552 patients were identified including 2749 and 3803 patients in the younger and the older groups; respectively. After PSM, 2383 patients were included in each group. There were no statistical differences among the baseline characteristics and the operative time across the matched groups. The rate of poUTI and procedure-related readmissions were significantly higher in the younger patients as compared to the older group either before or after PSM as seen in Table 1 (all; p<0.001). On multivariable analysis, younger patients had higher odds of poUTI (adjusted odds ratio (aOR): 1.92, 95% confidence interval (CI): 1.35-2.72, p<0.001) as well as higher odds of procedure-related readmissions (aOR: 2.42, 95% CI: 1.72-3.40, p<0.001) Conclusions: Three-year old children or younger were at increased risk of UTI and procedure-related readmissions after open UNC for VUR when compared to older patients. Study results should be interpreted with caution given the database limitations. Further validation of the current study findings is warranted. SOURCE OF Funding: None
