Comparison of pediatric surgical outcomes by the surgeon's degree of specialization in children
Comparison of pediatric surgical outcomes by the surgeon's degree of specialization in children
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DOI：
10.1016/j.jpedsurg.2012.12.048
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发表时间：
2013-08-01
影响因子：
2.4
通讯作者：
Abdullah, Fizan
中科院分区：
文献类型：
--
作者：
Rhee, Daniel;Papandria, Dominic;Abdullah, Fizan
简介：儿童手术结局的改善与儿科手术专业化相关，以前由外科医生手术量或奖学金培训定义。本研究通过对外科医生的儿科与成人手术experience.Methods的程度进行分类来评估儿科手术结果：一项横断面研究使用1998年至2007年的全国代表性出院数据进行。纳入接受神经外科、耳鼻喉科、心胸外科、普外科、骨科和泌尿外科住院手术的18岁以下患者。创建了一个指数，计算每个外科医生治疗的儿童比例。通过指数四分位数比较住院死亡率和住院时间。多变量分析调整了患者和医院的特点。结果：共有119,164例患者由13,141名外科医生进行手术。在心胸外科手术中，分别为1.78（p=0.02）和2.61（p
Introduction: Improved surgical outcomes in children have been associated with pediatric surgical specialization, previously defined by surgeon operative volume or fellowship training. The present study evaluates pediatric surgical outcomes through classifying surgeons by degrees of pediatric versus adult operative experience.Methods: A cross-sectional study was performed using nationally representative hospital discharge data from 1998 to 2007. Patients under 18 years of age undergoing inpatient operations in neurosurgery, otolaryngology, cardiothoracic, general surgery, orthopedic surgery, and urology were included. An index was created, calculating the proportion of children treated by each surgeon. In-hospital mortality and length of stay were compared by index quartiles. Multivariate analysis was adjusted for patient and hospital characteristics.Results: A total of 119,164 patients were operated on by 13,141 surgeons. Within cardiothoracic surgery, there were 1.78 (p=0.02) and 2.61 (p