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https://www.readbyqxmd.com/read/29155269/influence-of-time-to-appendectomy-and-operative-duration-on-hospital-cost-in-children-with-uncomplicated-appendicitis
#1
Stephanie K Serres, Dionne A Graham, Charity C Glass, Danielle B Cameron, Seema P Anandalwar, Shawn J Rangel
BACKGROUND: The goal of this study was to examine the influence of time to appendectomy (TTA) and operative duration (OD) on hospital cost as surrogate measures of perioperative efficiency. STUDY DESIGN: Retrospective cohort analysis of 2,116 children undergoing appendectomy for uncomplicated appendicitis at 16 children's hospitals from 1/2013 to 12/2014. TTA (emergency department presentation to incision) and OD were obtained from the NSQIP-Pediatric Appendectomy Pilot Database and merged with cost data from the Pediatric Health Information System Database...
November 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28965454/risk-factors-associated-with-short-term-complications-and-mortality-after-pediatric-spinal-arthrodesis
#2
Nancy Abu-Bonsrah, C Rory Goodwin, Gezzer Ortega, Fizan Abdullah, Edward Cornwell, Rafael De la Garza-Ramos, Mari L Groves, Michael Ain, Paul D Sponseller, Daniel M Sciubba
OBJECTIVE Spinal arthrodesis is routinely performed in the pediatric population. However, there is limited information on the short-term outcomes of pediatric patients who have undergone spine fusion. Thus, the authors conducted a retrospective review of the Pediatric National Surgical Quality Improvement Program (NSQIP) database to determine the short-term mortality, complication, reoperation, and readmission rates of pediatric patients who underwent spinal arthrodesis for all indications. METHODS The Pediatric NSQIP database was queried for all patients who underwent spinal arthrodesis between 2012 and 2014...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28953606/an-analysis-of-safety-and-adverse-events-following-cochlear-implantation-in-children-under-12-months-of-age
#3
Yesul Kim, Vijay A Patel, Huseyin Isildak, Michele M Carr
OBJECTIVE: To determine perioperative morbidity of children ≤12 months undergoing cochlear implantation (CI). STUDY DESIGN: Retrospective analysis using the American College of Surgeons National Surgical Quality Improvement Program Pediatric Database (ACS-NSQIP-P). SETTING: General acute care children's hospitals, children's hospitals within larger hospitals, specialty children's hospitals, and general acute care hospitals with a pediatric wing...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28941929/minimizing-variance-in-care-of-pediatric-blunt-solid-organ-injury-through-utilization-of-a-hemodynamic-driven-protocol-a-multi-institution-study
#4
Aaron J Cunningham, Katrine M Lofberg, Sanjay Krishnaswami, Marilyn W Butler, Kenneth S Azarow, Nicholas A Hamilton, Elizabeth A Fialkowski, Pamela Bilyeu, Erika Ohm, Erin C Burns, Margo Hendrickson, Preetha Krishnan, Cynthia Gingalewski, Mubeen A Jafri
BACKGROUND: An expedited recovery protocol for management of pediatric blunt solid organ injury (spleen, liver, and kidney) was instituted across two Level 1 Trauma Centers, managed by nine pediatric surgeons within three hospital systems. METHODS: Data were collected for 18months on consecutive patients after protocol implementation. Patient demographics (including grade of injury), surgeon compliance, National Surgical Quality Improvement Program (NSQIP) complications, direct hospital cost, length of stay, time in the ICU, phlebotomy, and re-admission were compared to an 18-month control period immediately preceding study initiation...
September 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#5
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28749483/surgical-site-infections-in-neonates-are-independently-associated-with-longer-hospitalizations
#6
E A Gilje, M J Hossain, C D Vinocur, L Berman
OBJECTIVE: There is limited data characterizing the risk and impact of surgical site infection (SSI) in neonates; this makes it difficult to identify factors that increase neonatal SSI risk and to determine how SSI affects outcomes in this special population. STUDY DESIGN: The American College of Surgeons National Surgical Improvement Program Pediatric (NSQIP-P) collected data on children undergoing surgery at children's hospitals from 2012 to 2014. Neonates undergoing general surgical procedures were characterized with regard to demographic characteristics and comorbidities...
October 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28693849/impact-of-outpatient-management-following-appendectomy-for-acute-appendicitis-an-acs-nsqip-p-analysis
#7
Cristen N Litz, Laurie Stone, Roberta Alessi, Nebbie E Walford, Paul D Danielson, Nicole M Chandler
BACKGROUND: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. METHODS: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes...
June 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28675096/adverse-events-in-endoscopic-sinus-surgery-for-infectious-orbital-complications-of-sinusitis-30-day-nsqip-pediatric-outcomes
#8
MULTICENTER STUDY
Jeffrey Cheng, Beiyu Liu, Alfredo E Farjat, David W Jang
Objective Identify predictors of adverse events for children who underwent endoscopic sinus surgery for treatment of orbital complications associated with sinusitis. Study Design Cross-sectional analysis of a US national database. Setting American College of Surgeons National Surgical Quality Improvement Program (NSQIP), pediatric version (2012-2015). Subjects and Methods Patients were identified with a combination of codes from the International Classification of Diseases, Ninth Revision and 2014 Current Procedural Terminology...
October 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28654543/extended-versus-narrow-spectrum-antibiotics-in-the-management-of-uncomplicated-appendicitis-in-children-a-propensity-matched-comparative-effectiveness-study
#9
Danielle B Cameron, Patrice Melvin, Dionne A Graham, Charity C Glass, Stephanie K Serres, Matthew P Kronman, Jacqueline M Saito, Shawn J Rangel
OBJECTIVE: The aim of this study was to compare the effectiveness of extended versus narrow spectrum antibiotics in preventing surgical site infections (SSIs) and hospital revisits in children with uncomplicated appendicitis. SUMMARY OF BACKGROUND DATA: There is a paucity of high-quality evidence in the pediatric literature comparing the effectiveness of extended versus narrow-spectrum antibiotics in the prevention of SSIs associated with uncomplicated appendicitis...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28648327/incidence-of-acute-complications-following-surgery%C3%A2-for-syndactyly-and-polydactyly-an-analysis-of-the-national-surgical-quality-improvement-program-database-from-2012-to-2014
#10
Thomas J McQuillan, Jessica E Hawkins, Amy L Ladd
PURPOSE: Congenital hand differences are infrequent phenomena, and their treatment represents a relatively small fraction of cases performed by hand surgeons. Little is known about the incidence of wound complications and acute postoperative problems given the relative rarity of these procedures. This study sought to characterize the incidence of complications within 30 days of surgery for congenital hand differences. METHODS: The National Surgical Quality Improvement Program (NSQIP) contains prospective data regarding 30-day morbidity from 64 pediatric centers across the United States...
September 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28595843/analysis-of-risk-factors-associated-with-unplanned-reoperations-following-pediatric-plastic-surgery
#11
Kevin T Jubbal, Dmitry Zavlin, Edward P Buchanan, Larry H Hollier
BACKGROUND/PURPOSE: Unplanned reoperation (UR) is an outcome measure with multiple advantages that can be used as a standardized tool to assess an institution's quality and safety of medical care. This study aimed to identify parameters associated with an increased likelihood of UR following plastic surgery in patients less than 18 years of age by using a large validated national multicenter database. METHODS/DESCRIPTION: We performed a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric database between 2012 and 2014 to identify pediatric patients undergoing primary plastic surgery procedures...
October 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28544520/safety-and-perioperative-adverse-events-in-pediatric-endoscopic-sinus-surgery-an-acs-nsqip-p-analysis
#12
Christopher R Roxbury, Lilun Li, Daniel Rhee, Kris R Jatana, Rahul K Shah, Emily F Boss
INTRODUCTION: This study describes safety outcomes of pediatric endoscopic sinus surgery (ESS) to identify risk factors for 30-day postoperative adverse events using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHODS: We performed a retrospective cohort study involving patients in the 2012-2015 NSQIP-P database who underwent ESS. Predictors included demographics, comorbidities and surgical acuity. Outcomes included 30-day complications, reoperations, and readmissions...
August 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28501899/is-there-a-july-effect-in-pediatric-neurosurgery
#13
Yimo Lin, Rory R Mayer, Terence Verla, Jeffrey S Raskin, Sandi Lam
PURPOSE: The belief that July, when resident physicians' training year begins, may be associated with increased risk of patient morbidity and mortality is known as the "July effect." This study aimed to compare complication rates after pediatric neurosurgical procedures in the first versus last academic quarters in two national datasets. METHODS: Data were extracted from the National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) database for year 2012 for 30-day complication events and the Kids' Inpatient Database (KID) for year 2012 for in-hospital complication events after pediatric neurosurgical procedures...
August 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28463634/comparing-30-day-morbidity-and-mortality-in-pediatric-and-adult-otologic-surgery
#14
MULTICENTER STUDY
Zachary G Schwam, Elias Michaelides, Jennifer R Schwam, Phoebe Kuo, Michael A Hajek, Benjamin L Judson, Christopher Schutt
Objective To determine differences in timing and rate of postoperative adverse events among pediatric and adult populations undergoing specific otologic procedures. Study Design Administrative database study. Setting Multi-institutional database. Subjects and Methods The National Surgical Quality Improvement Program (NSQIP) and NSQIP-Pediatric (NSQIP-P) were used to extract data from 819 adults (years 2005-2010) and 7020 children (years 2012-2014) undergoing tympanoplasty and (tympano)mastoidectomy, respectively...
November 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28408077/does-timing-of-gastroschisis-repair-matter-a-comparison-using-the-acs-nsqip-pediatric-database
#15
Lori A Gurien, Melvin S Dassinger, Jeffrey M Burford, Marie E Saylors, Samuel D Smith
BACKGROUND: There is no consensus on optimal timing of gastroschisis repair. The 2012-2014 ACS NSQIP Pediatric Participant Use Data File was used to compare outcomes of primary versus staged gastroschisis repair. METHODS: Cases were divided into primary repair (0-1day) and staged repair (4-14days). Baseline characteristics and outcomes were compared for primary versus staged closure using Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables...
November 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28344019/open-versus-minimally-invasive-surgical-approaches-in-pediatric-urology-trends-in-utilization-and-complications
#16
Rohit Tejwani, Brian J Young, Hsin-Hsiao S Wang, Steven Wolf, J Todd Purves, John S Wiener, Jonathan C Routh
OBJECTIVE: Minimally invasive surgery (MIS) techniques are anecdotally reported to be increasingly used, but little objective data supports this. Our objective was to assess trends in MIS utilization across various procedures in pediatric urology and to compare postoperative complication rates between MIS and open procedures. METHODS: We analyzed the 1998-2012 Nationwide Inpatient Sample. We identified children (<18 years old) undergoing open and MIS inpatient procedures and any in-hospital post-operative complications that occurred during that postoperative hospitalization...
June 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28343665/defining-the-association-between-operative-time-and-outcomes-in-children-s-surgery
#17
Heather L Short, Helene B Fevrier, Jonathan A Meisel, Matthew T Santore, Kurt F Heiss, Mark L Wulkan, Mehul V Raval
INTRODUCTION: Prolonged operative time (OT) is considered a reflection of procedural complexity and may be associated with poor outcomes. Our purpose was to explore the association between prolonged OT and complications in children's surgery. METHODS: 182,857 cases from the 2012-2014 NSQIP-Pediatric were organized into 33 groups. OT for each group was analyzed by quartile, and regression models were used to determine the relationship between prolonged OT and complications...
March 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28238822/does-receiving-a-blood-transfusion-predict-for-length-of-stay-in-children-undergoing-cranial-vault-remodeling-for-craniosynostosis-outcomes-using-the-pediatric-national-surgical-quality-improvement-program-dataset
#18
Michael R Markiewicz, Tord Alden, Mohmed Vasim Momin, Alexis B Olsson, Ray J Jurado, Fizan Abdullah, Michael Miloro
PURPOSE: Recent interventions have aimed at reducing the need for blood transfusions in the perioperative period in patients with craniosynostosis undergoing cranial vault remodeling. However, little is known regarding whether the receipt of a blood transfusion influences the length of hospital stay. The purpose of this study was to assess whether the receipt of a blood transfusion in patients undergoing cranial vault remodeling is associated with an increased length of stay. MATERIALS AND METHODS: To address the research purposes, we designed a retrospective cohort study using the 2014 Pediatric National Surgical Quality Improvement Program (NSQIP Peds) dataset...
August 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28235646/identifying-adverse-events-in-pediatric-surgery-comparing-morbidity-and-mortality-conference-with-the-nsqip-pediatric-system
#19
Barrett P Cromeens, Richard E Lisciandro, Richard J Brilli, Johanna R Askegard-Giesmann, Brian D Kenney, Gail E Besner
BACKGROUND: Recent improvements to morbidity and mortality (M&M) conference have focused on the case review system. However, case selection occurs by physician reporting, which is limited by selection bias. We compared the effectiveness of our M&M conference with the NSQIP-Pediatric (NSQIP-P) system for identifying adverse events. STUDY DESIGN: Complications from January 2010 to September 2015 were compared between M&M and NSQIP-P. Only M&M patients meeting NSQIP-P criteria were compared with patients from the NSQIP-P system; exclusions were studied separately...
May 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28190557/moving-the-needle-toward-high-quality-pediatric-surgical-care-how-can-we-achieve-this-goal-through-prioritization-measurement-and-more-effective-collaboration
#20
REVIEW
Shawn J Rangel
Over the past decade, the American College of Surgeons Pediatric National Surgical Quality Improvement Program (NSQIP-Pediatric) has greatly improved upon our ability to measure, benchmark and compare outcomes as they relate to pediatric surgical care. Several factors have served to mold the program's evolution and data collection paradigm over time. These have included a broader understanding of what quality measures should be captured and compared from the perspectives of different stakeholders, identification of conditions where quality and process improvement efforts may have the greatest relative impact from a public health perspective, and increasing evidence in support of collaborative networks to accelerate quality improvement through the dissemination of best practices...
May 2017: Journal of Pediatric Surgery
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