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Nsqip pediatrics

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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
#1
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...
February 3, 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
#2
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...
February 22, 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
#3
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...
January 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28186476/risk-factors-for-surgical-site-infection-following-nonshunt-pediatric-neurosurgery-a-review-of-9296-procedures-from-a-national-database-and-comparison-with-a-single-center-experience
#4
Brandon A Sherrod, Anastasia A Arynchyna, James M Johnston, Curtis J Rozzelle, Jeffrey P Blount, W Jerry Oakes, Brandon G Rocque
OBJECTIVE Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) database for the years 2012-2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28186474/morbidity-associated-with-30-day-surgical-site-infection-following-nonshunt-pediatric-neurosurgery
#5
Brandon A Sherrod, Brandon G Rocque
OBJECTIVE Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. METHODS The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2014 database, including all neurosurgical procedures performed on pediatric patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28102467/mypod-an-emr-based-tool-that-facilitates-quality-improvement-and-maintenance-of-certification
#6
Loren Berman, Brian Duffy, B Randall Brenn, Charles Vinocur
Maintenance of Certification (MOC) was designed to assess physician competencies including operative case volume and outcomes. This information, if collected consistently and systematically, can be used to facilitate quality improvement. Information automatically extracted from the electronic medical record (EMR) can be used as a prompt to compile these data. We developed an EMR-based program called MyPOD (My Personal Outcomes Data) to track surgical outcomes at our institution. We compared occurrences reported in the first 18 months to those captured in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) over the same time period...
March 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28089474/what-happened-to-the-complication-the-importance-of-acs-nsqip-pediatric-in-optimizing-quality-improvement-initiatives-for-resident-education
#7
Bennett W Calder, Joseph V Sakran, Christian J Streck, Robert A Cina
OBJECTIVE: Morbidity and Mortality (M&M) conference is considered the golden hour of surgical education. Most training programs lack standardized methods to evaluate self-reported outcomes and contributions to resident education. The purpose of this study was to determine whether residents underreport pediatric postoperative complications thereby limiting a comprehensive educational opportunity and the ability to adequately perform quality improvement during M&M conference. DESIGN: A retrospective analysis of resident reports submitted to the M&M committee at an academic medical center was conducted over 1 year...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28069525/utilization-of-the-nsqip-pediatric-database-in-development-and-validation-of-a-new-predictive-model-of-pediatric-postoperative-wound-complications
#8
Ilan I Maizlin, David T Redden, Elizabeth A Beierle, Mike K Chen, Robert T Russell
BACKGROUND: Surgical wound classification, introduced in 1964, stratifies the risk of surgical site infection (SSI) based on a clinical estimate of the inoculum of bacteria encountered during the procedure. Recent literature has questioned the accuracy of predicting SSI risk based on wound classification. We hypothesized that a more specific model founded on specific patient and perioperative factors would more accurately predict the risk of SSI. STUDY DESIGN: Using all observations from the 2012 to 2014 pediatric National Surgical Quality Improvement Program-Pediatric (NSQIP-P) Participant Use File, patients were randomized into model creation and model validation datasets...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28059679/perioperative-outcomes-for-pediatric-neurosurgical-procedures-analysis-of-the-national-surgical-quality-improvement-program-pediatrics
#9
Benjamin J Kuo, Joao Ricardo N Vissoci, Joseph R Egger, Emily R Smith, Gerald A Grant, Michael M Haglund, Henry E Rice
OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform...
March 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28039511/increased-morbidity-and-mortality-in-cardiac-patients-undergoing-fundoplication
#10
Heather L Short, Curtis Travers, Courtney McCracken, Mark L Wulkan, Matthew S Clifton, Mehul V Raval
BACKGROUND: Infants with congenital cardiac disease (CCD) often require gastrostomy tube placement (GT) and need antireflux procedures, such as fundoplications. Our purpose was to compare morbidity/mortality rates among infants with CCD undergoing GT, fundoplication, or both. METHODS: Using the NSQIP-Pediatric, we identified 4070 patients <1-year-old who underwent GT and/or fundoplication from 2012 to 2014. 2346 infants (58%) had CCD categorized as minor, major or severe...
December 30, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/28032565/surgical-site-infection-after-stoma-closure-in-children-outcomes-and-predictors
#11
Dani O Gonzalez, Erica Ambeba, Peter C Minneci, Katherine J Deans, Benedict C Nwomeh
BACKGROUND: Surgical site infection (SSI) is a burdensome complication following intestinal stoma closure, with reported rates ranging from 0% to 40%. We aimed to identify risk factors for SSI in children undergoing stoma closure. MATERIALS AND METHODS: Using 2012-2014 NSQIP Pediatric data, we identified patients aged 0-18 years undergoing stoma closure. Demographic, clinical, and 30-day outcome characteristics between children with and without SSI were compared...
November 4, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#12
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
March 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28009537/overweight-and-obese-pediatric-patients-have-an-increased-risk-of-developing-a-surgical-site-infection
#13
Brian P Blackwood, Colin D Gause, Jamie C Harris, Christina M Theodorou, Irene Helenowski, Timothy B Lautz, Julia Grabowski, Catherine J Hunter
BACKGROUND: Obesity is a known risk factor in adult surgical site infections (SSIs), but its significance in pediatrics is unclear. We hypothesized that overweight and obese children have increased risk for SSI. PATIENTS AND METHODS: A National Surgical Quality Improvement Program-Pediatric (NSQIP-P) file and single-center reviews identified surgical patients (2-18 years) who developed SSIs. Patients were classified as underweight, normal, overweight, or obese based on body mass index (BMI)...
December 23, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27894758/the-impact-of-cardiac-risk-factors-on-short-term-outcomes-for-children-undergoing-a-ladd-procedure
#14
Luke R Putnam, Kathryn T Anderson, KuoJen Tsao, Lillian S Kao, Jane A Lugo, Kevin P Lally, Akemi L Kawaguchi
BACKGROUND/PURPOSE: The purpose of this study was to describe the outcomes of children with and without congenital heart disease who undergo a Ladd procedure. METHODS: The 2012-2014 National Surgical Quality Improvement Program Pediatric (NSQIP-P) data were queried for patients undergoing a Ladd procedure. Utilizing NSQIP-P definitions, patients were categorized into four cardiac risk groups (none, minor, major, severe) based on severity of cardiac anomalies, previous cardiac procedure(s), and ongoing cardiac dysfunction...
October 21, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27884453/a-call-for-a-standardized-definition-of-perforated-appendicitis
#15
Andrew P Rogers, Tiffany J Zens, Charles M Leys, Peter F Nichol, Daniel J Ostlie
BACKGROUND: Abscess rates have been reported to be as low as 1% and as high as 50% following perforated appendicitis (PA). This range may be because of lack of universal definition for PA. An evidence-based definition (EBD) is crucial for accurate wound classification, risk-stratification, and subsequent process optimization. ACS NSQIP-Pediatric guidelines do not specify a definition of PA. We hypothesize that reported postoperative abscess rates underrepresent true incidence, as they may include low-risk cases in final calculations...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27870741/relationship-between-preoperative-anemia-and-in-hospital-mortality-in-children-undergoing-noncardiac-surgery
#16
David Faraoni, James A DiNardo, Susan M Goobie
BACKGROUND: The relationship between preoperative anemia and in-hospital mortality has not been investigated in the pediatric surgical population. We hypothesized that children with preoperative anemia undergoing noncardiac surgery may have an increased risk of in-hospital mortality. METHODS: We identified all children between 1 and 18 years of age with a recorded preoperative hematocrit (HCT) in the 2012, 2013, and 2014 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) pediatric databases...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27666656/development-and-evaluation-of-the-american-college-of-surgeons-nsqip-pediatric-surgical-risk-calculator
#17
Kari Kraemer, Mark E Cohen, Yaoming Liu, Douglas C Barnhart, Shawn J Rangel, Jacqueline M Saito, Karl Y Bilimoria, Clifford Y Ko, Bruce L Hall
BACKGROUND: There is an increased desire among patients and families to be involved in the surgical decision-making process. A surgeon's ability to provide patients and families with patient-specific estimates of postoperative complications is critical for shared decision making and informed consent. Surgeons can also use patient-specific risk estimates to decide whether or not to operate and what options to offer patients. Our objective was to develop and evaluate a publicly available risk estimation tool that would cover many common pediatric surgical procedures across all specialties...
November 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27528852/reliability-of-a-surgeon-reported-morbidity-and-mortality-database-a-comparison-of-short-term-morbidity-between-the-scoliosis-research-society-and-national-surgical-quality-improvement-program-databases
#18
Christopher T Martin, Andrew J Pugely, Yubo Gao, Branko Skovrlj, Nathan J Lee, Samuel K Cho, Sergio Mendoza-Lattes
BACKGROUND: There exists a lack of comparison between large national healthcare databases reporting surgical morbidity and mortality. Prior authors have expressed concern that the Scoliosis Research Society (SRS) membership may have underreported complications in spinal surgery. Thus, the purpose of the present study was to compare the incidence of morbidity between the SRS and National Surgical Quality Improvement Program (NSQIP) databases. METHODS: We reviewed patients enrolled between 2012 and 2013, with a total of 96,875 patients identified in the SRS dataset and 15,909 in the combined adult and pediatric NSQIP dataset...
2016: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/27490129/predictors-of-ventriculoperitoneal-shunt-failure-in-children-undergoing-initial-placement-or-revision
#19
Dani O Gonzalez, Justin B Mahida, Lindsey Asti, Erica J Ambeba, Brian Kenney, Lance Governale, Katherine J Deans, Peter C Minneci
BACKGROUND: Ventriculoperitoneal (VP) shunt placement, the mainstay of treatment for hydrocephalus, can place a substantial burden on patients and health care systems because of high complication and revision rates. We aimed to identify factors associated with 30-day VP shunt failure in children undergoing either initial placement or revision. METHODS: VP shunt placements performed on patients in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Pediatric were identified...
2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27411903/safety-and-postoperative-adverse-events-in-pediatric-airway-reconstruction-analysis-of-acs-nsqip-p-30-day-outcomes
#20
Christopher R Roxbury, Kris R Jatana, Rahul K Shah, Emily F Boss
OBJECTIVES: Prior research has shown that airway reconstructive procedures comprise significant composite morbidity compared to the whole of pediatric otolaryngologic cases evaluated in the American College of Surgeon's National Surgery Quality Improvement Program-Pediatric (ACS-NSQIP-P) platform. We describe postoperative sequelae of pediatric airway reconstructive procedures and identify predictive factors for adverse events. METHODS: Current procedural terminology (CPT) codes were used to identify children undergoing included procedures in the 2012 to 2014 ACS-NSQIP-P public use files (PUF)...
February 2017: Laryngoscope
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