Is NSQIP Pediatric review representative of total institutional experience for children undergoing appendectomy?

Autor: Duggan EM; Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA. Electronic address: Eileen.m.duggan@vanderbilt.edu., Gates DW; Department of Performance Management and Improvement, Monroe Carrell, Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA., Slayton JM; Department of Performance Management and Improvement, Monroe Carrell, Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA., Blakely ML; Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2014 Aug; Vol. 49 (8), pp. 1292-4. Date of Electronic Publication: 2013 Oct 17.
DOI: 10.1016/j.jpedsurg.2013.10.007
Abstrakt: Background/purpose: NSQIP Pediatric (NSQIP-P) is a robust quality improvement effort. A limitation of the NSQIP process lies in capturing a small proportion of the total case volume. This study examines whether appendectomies captured by NSQIP-P are concordant with all appendectomies, the most commonly captured procedure in 2011.
Methods: We compared case mix and 30-day outcomes between children undergoing an appendectomy who were included in NSQIP (n=80) and children not captured by NSQIP (n=276) during 2011 at a tertiary referral children's hospital. A single surgical case reviewer reviewed all cases using NSQIP-P methodology.
Results: NSQIP-P captured 80 of a total of 356 appendectomies (22%). The case mix was similar between NSQIP and non-NSQIP groups (e.g., 31% of each group had complicated appendicitis). Outcomes were also similar; post-operative occurrences, readmissions and return to the operation room occurred at rates of 7.5% vs. 7.6%, 5% vs. 4.7%, and 3.8% vs. 4.3% respectively.
Conclusion: Although NSQIP-P captured a minority of the total patient population that had an appendectomy, the case mix and outcomes were similar. Our results offer reassurance that NSQIP-P data are representative of the larger population for this procedure. Whether this concordance exists for procedures less commonly performed is unknown and a focus of ongoing work.
(© 2014.)
Databáze: MEDLINE
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