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https://www.readbyqxmd.com/read/29925468/hospital-type-predicts-computed-tomography-use-for-pediatric-appendicitis
#1
Kathryn Tinsley Anderson, Marisa A Bartz-Kurycki, Mary T Austin, Akemi L Kawaguchi, Lillian S Kao, Kevin P Lally, Kuojen Tsao
BACKGROUND: Evidence-based guidelines recommend ultrasound (US) over computed tomography (CT) as the primary imaging modality for suspected pediatric appendicitis. Continued high rates of CT use may result in significant unnecessary radiation exposure in children. The purpose of this study was to evaluate variables associated with preoperative CT use in pediatric appendectomy patients. METHODS: A retrospective cohort study of pediatric patients who underwent appendectomy for acute appendicitis in 2015-2016 at National Surgical Quality Improvement Program for Pediatrics (NSQIP-P) hospitals was conducted...
May 29, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29900688/outpatient-management-and-surgeon-specialty-for-thyroglossal-duct-cyst-excision-a-retrospective-analysis-of-377-patients-and-30-day-outcomes-in-the-american-college-of-surgeons-nsqip-p-database
#2
Douglas R Farquhar, Rounak B Rawal, Maheer M Masood, Wade G McClain, Lauren A Kilpatrick, Austin S Rose, Carlton J Zdanski
Thyroglossal duct cysts (TGDC) excisions was traditionally an inpatient procedure, but there has been a recent trend towards outpatient surgery. Our aim is to use the NSQIP-P to examine overall thirty-day outcomes for TGDC excision, and to determine whether they are affected by admission status and surgeon specialty. We assessed the demographics, preoperative risk factors, and negative outcomes of admitted and same-day surgery TGDC patients, and TGDC patients of surgeons with different training. Outcomes were thirty-day rates for readmissions, reoperations, unplanned reintubations, major complications, and minor complications...
June 14, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29877982/evaluating-the-national-surgical-quality-improvement-program-pediatric-surgical-risk-calculator-for-pediatric-craniosynostosis-surgery
#3
Nisha Gadgil, I-Wen Pan, Solomon Babalola, Sandi Lam
BACKGROUND: The American College of Surgeons' National Surgical Quality Improvement Program-Pediatric (NSQIP-P) risk calculator was developed based on national data. There have been no studies assessing the risk calculator's performance in pediatric neurosurgery. The authors aimed to evaluate the predictions from the risk calculator compared to our single institution experience in craniosynostosis surgery. METHODS: Outcomes from craniosynostosis surgeries performed between 2012 and 2016 at our academic pediatric hospital were evaluated using the NSQIP-P risk calculator...
June 5, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29843908/malnutrition-increases-the-risk-of-30-day-complications-after-surgery-in-pediatric-patients-with-crohn-disease
#4
Mitchell R Ladd, Alejandro V Garcia, Ira L Leeds, Courtney Haney, Maria M Oliva-Hemker, Samuel Alaish, Emily Boss, Daniel S Rhee
BACKGROUND: Pediatric patients with Crohn disease (CD) are frequently malnourished, yet how this affects surgical outcomes has not been evaluated. This study aims to determine the effects of malnourishment in children with CD on 30-day outcomes after surgery. STUDY DESIGN: The ACS NSQIP-Pediatric database from 2012 to 2015 was used to select children aged 5-18 with CD who underwent bowel surgery. BMI-for-age Z-scores were calculated based on CDC growth charts and 2015 guidelines of pediatric malnutrition were applied to categorize severity of malnutrition into none, mild, moderate, or severe...
April 27, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29784455/incidence-and-risk-factors-associated-with-30-day-post-operative-venous-thromboembolism-a-nsqip-pediatric-analysis
#5
Jennifer J Ahn, Paul A Merguerian, Margarett Shnorhavorian
INTRO: Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. OBJECTIVE: The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. STUDY DESIGN: All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE...
May 8, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29743805/outcomes-after-endoscopic-dilation-of-laryngotracheal-stenosis-an-analysis-of-acs-nsqip
#6
Avni Bavishi, Emily Boss, Rahul K Shah, Jennifer Lavin
Importance: Endoscopic management of pediatric subglottic stenosis (SGS) is common, however no multi-institutional studies have assessed its perioperative outcomes. The American College of Surgeon's National Surgical Quality Improvement Program - Pediatric (ACS-NSQIP-P) represents a source of such data. Design: Current procedural terminology (CPT) codes were queried for endoscopic or open airway reconstruction in the ACS-NSQIP-P Public Use File (PUF). Demographics and 30-day events were abstracted to compare open to endoscopic techniques and to assess for risk factors for varied outcomes after endoscopic dilation...
March 2018: Journal of Clinical Outcomes Management: JCOM
https://www.readbyqxmd.com/read/29680415/home-antibiotics-at-discharge-for-pediatric-complicated-appendicitis-friend-or-foe
#7
K Tinsley Anderson, Marisa A Bartz-Kurycki, Akemi L Kawaguchi, Mary T Austin, Galit Holzmann-Pazgal, Lillian S Kao, Kevin P Lally, Kuojen Tsao
BACKGROUND: The role of home antibiotics (HA) at discharge in children after perforated appendicitis is unclear. This study evaluates the outcomes of complicated appendicitis in patients being discharged with or without HA after initial operation and inpatient treatment. STUDY DESIGN: The 2015 and 2016 NSQIP-Pediatric database was queried for patients younger than 18 years of age with complicated appendicitis. Home antibiotics were prescribed or not (no home antibiotics [NHA])...
April 20, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29661575/outcomes-of-laparoscopic-resection-of-meckel-s-diverticulum-are-equivalent-to-open-laparotomy
#8
Brian Ezekian, Harold J Leraas, Brian R Englum, Brian F Gilmore, Christopher Reed, Tamara N Fitzgerald, Henry E Rice, Elisabeth T Tracy
PURPOSE: Meckel's diverticulum (MD) is a common congenital anomaly caused by failure of involution of the omphalomesenteric duct. Enthusiasm for minimally invasive surgery (MIS) in children has burgeoned as technologies have advanced, but the outcomes of laparoscopic resection in comparison to open laparotomy for MD remain poorly defined. We queried a large national database to compare current practice patterns and clinical outcomes between surgical approaches for MD in the pediatric population...
March 15, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29617521/practical-guide-to-surgical-data-sets-national-surgical-quality-improvement-program-nsqip-and-pediatric-nsqip
#9
Mehul V Raval, Timothy M Pawlik
No abstract text is available yet for this article.
April 4, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29605342/safety-and-postoperative-adverse-events-in-management-of-acute-mastoiditis-in-children-30-day-nsqip-outcomes
#10
Matthew G Crowson, Jeffrey Cheng
OBJECTIVE: To examine preoperative risk factors, postoperative 30-day outcomes and adverse events of acute mastoiditis using a national pediatric surgical database. METHODS: We explored our objectives using a cross-sectional analysis of a hospital-based reporting system database. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) pediatric database was used to identify surgical encounters for the treatment of acute mastoiditis from 2012 to 2015...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29602551/relationship-between-perioperative-blood-transfusion-and-surgical-site-infections-in-pediatric-general-and-thoracic-surgical-patients
#11
Jason Fawley, Thomas H Chelius, Marjorie J Arca
BACKGROUND: Recently, perioperative transfusions were demonstrated to be associated with higher rate of surgical site infections (SSIs) in neonates. We sought to examine whether a similar relationship exists between perioperative blood transfusions and SSI among non-neonatal pediatric general surgical patients. METHODS: We conducted an IRB-approved retrospective study reviewing non-neonatal patients (age greater than 28days and less than 18years) who underwent a general or thoracic surgical procedure in 2012, 2013, 2014, in the American College of Surgeons National Safety and Quality Improvement Project-Pediatric (ACS-NSQIP-P) Participant User Files...
March 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29602550/minimally-invasive-repair-of-pectus-excavatum-analysis-of-the-nsqip-database-and-the-use-of-thoracoscopy
#12
Oswald Tetteh, Daniel S Rhee, Emily Boss, Samuel M Alaish, Alejandro V Garcia
BACKGROUND: The minimally invasive repair of pectus excavatum (MIRPE) has been widely accepted and has become a viable alternative to the open Ravitch technique. MIRPE has evolved over time with some advocating that a safe repair can be accomplished without direct visualization utilizing thoracoscopy. The MIRPE with and without a thoracoscopic approach has not been previously analyzed from a nationwide database to determine differences in safety and short-term outcomes. METHODS: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2015 database was used in identifying patients that had MIRPE using Current Procedural Terminology (CPT) codes and ICD-9CM/ICD-10CM postoperative diagnosis codes...
March 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29572808/readmission-and-complications-within-30-days-after-intrathecal-baclofen-pump-placement
#13
Sandi K Lam, Rory R Mayer, Aditya Vedantam, Kristen A Staggers, Dominic A Harris, I-Wen Pan
AIM: To describe 30-day outcomes after intrathecal baclofen (ITB) pump placement in children and identify risk factors for readmission, reoperation, and perioperative complication using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHOD: Patients aged 0 to 18 years who underwent ITB pump placement (2012-2014) comprised the study cohort defined in the database. Multivariate regression analysis was performed using preoperative and perioperative data from the American College of Surgeons' NSQIP-P database...
March 23, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29525534/the-evaluation-of-three-comorbidity-indices-in-predicting-postoperative-complications-and-readmissions-in-pediatric-urology
#14
Ruiyang Jiang, Steven Wolf, Muhammad H Alkazemi, Gina-Maria Pomann, J Todd Purves, John S Wiener, Jonathan C Routh
INTRODUCTION: The surgical comorbidity assessment is important for patient risk stratification, counseling, and research. In adults, risk assessment indices, such as the Charlson Co-morbidity Score (CCS) or Van Walraven Index (VWI), are well established. In pediatrics, however, risk assessment indices are scarce. Recently, a pediatric-specific risk assessment index, the Rhee index, was developed to discriminate mortality for pediatric general surgery patients. Currently, there is no validated risk assessment tool in pediatric urology...
February 26, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29499844/the-relationship-between-preoperative-nutritional-state-and-adverse-outcome-following-abdominal-and-thoracic-surgery-in-children-results-from-the-nsqip-database
#15
Abdullah Alshehri, Kourosh Afshar, Julie Bedford, Graeme Hintz, Erik D Skarsgard
INTRODUCTION: Anthropometric measurements can be used to define pediatric malnutrition. Our study aims to: (1) characterize the preoperative nutritional status of children undergoing abdominal or thoracic surgery, and (2) describe the associations between WHO-defined acute (stunting) and chronic (wasting) undernutrition (Z-scores <-2) and obesity (BMI Z-scores >+2) with 30-day postoperative outcomes. METHODS: We queried the Pediatric NSQIP Participant Use File and extracted data on patients' age 29days to 18years who underwent abdominal or thoracic procedures...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29453133/mortality-after-emergency-abdominal-operations-in-premature-infants
#16
Sarah B Cairo, Benjamin D Tabak, Loren Berman, Sara K Berkelhamer, Guan Yu, David H Rothstein
CONTEXT/BACKGROUND: To determine risk of 30-day mortality for premature infants undergoing abdominal operations during the first 2 months of life and to identify risk factors for perioperative mortality using available demographic and clinical variables of interest. BASIC PROCEDURES: Retrospective descriptive analysis of premature infants (gestational age less than or equal to 36weeks) undergoing abdominal operations during the first 2 months of life using the American College of Surgeon's National Surgical Quality Improvement Project Pediatric (NSQIP-P, 2012-2015) database...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29405845/areas-for-quality-improvement-for-airway-dilation-in-children-nsqip-pediatric-30-day-outcomes
#17
Jeffrey Cheng, Beiyu Liu, Alfredo E Farjat
Objective To identify predictors of adverse events and highlight areas for quality improvement for children who underwent laryngeal or tracheal dilation, without prior tracheostomy placement. Study Design Cross-sectional analysis using a US national database. Setting American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS NSQIP-pediatric), years 2012 to 2015. Subjects and Methods Patients 18 years and younger were included. Patients without prior tracheostomy placement were identified using 2017 Current Procedural Terminology ( CPT) codes: 31528, 31529, and 31630...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29404734/hospital-variation-in-rates-of-concurrent-fundoplication-during-gastrostomy-enteral-access-procedures
#18
Anne M Stey, Charles D Vinocur, R Lawrence Moss, Bruce L Hall, Mark E Cohen, Kari Kraemer, Clifford Y Ko, Brian D Kenney, Loren Berman
BACKGROUND: This study aimed to determine whether (1) the propensity for concurrent fundoplication during gastrostomy varies among hospitals, and (2) postoperative morbidity differs among institutions performing fundoplication more or less frequently. METHODS: Children who underwent gastrostomy with or without concurrent fundoplication were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric (ACS-NSQIP-P). A hierarchical multivariate regression modeled the excess effects that hospitals exerted over propensity for concurrent fundoplication adjusting for preoperative clinical variables...
May 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29370891/risk-factors-for-venous-thromboembolic-events-in-pediatric-surgical-patients-defining-indications-for-prophylaxis
#19
Sarah B Cairo, Timothy B Lautz, Beverly A Schaefer, Guan Yu, Hibbut-Ur-Rauf Naseem, David H Rothstein
BACKGROUND: Venous thromboembolism (VTE) in pediatric surgical patients is a rare event. The risk factors for VTE in pediatric general surgery patients undergoing abdominopelvic procedures are unknown. STUDY DESIGN: The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database (2012-2015) was queried for patients with VTE after abdominopelvic general surgery procedures. Patient and operative variables were assessed to identify risk factors associated with VTE and develop a pediatric risk score...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29340829/trends-and-surgical-outcomes-of-laparoscopic-versus-open-pyloromyotomy
#20
William C Kethman, Alex H S Harris, Mary T Hawn, James K Wall
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is one of the most common pediatric illnesses necessitating surgical intervention. Controversy remains over the optimal surgical approach between laparoscopic pyloromyotomy (LP) and open pyloromyotomy (OP). LP has gained acceptance for management of HPS in an era of expanding minimal access surgical approaches to pediatric conditions. Several studies suggest advantages of LP over OP; however, selection bias and small sample sizes remain a concern...
January 16, 2018: Surgical Endoscopy
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