The growing population of children with medical complexity (CMC), especially those with neurologic impairment (NI), is increasingly the focus of researchers, clinician leaders, and policy makers. In this issue of Pediatrics, Mpody et al add to this emerging literature base by clearly demonstrating that NI, a common health condition among CMC, is strongly associated with postoperative pneumonia. Using data from the National Surgical Quality Improvement Program (NSQIP), the authors confirm what most pediatricians learn during training: compared with children without underlying neurologic comorbidities, children with NI are at significantly higher risk for developing pneumonia and experiencing prolonged hospitalizations after a surgical procedure.

This study raises important questions, some of which are noted by the authors. For example, which specific clinical characteristics put children with cerebral palsy or neuromuscular disorders at increased risk for postoperative pneumonia, and which ones are protective? Among children with NI, which surgical...

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