Pediatric National Surgical Quality Improvement Program: Useful for Quality Improvement in Craniosynostosis Surgery?
Pediatric National Surgical Quality Improvement Program: Useful for Quality Improvement in Craniosynostosis Surgery?
复制标题
儿科国家手术质量改进计划：对颅缝早闭手术质量改进有用吗？
DOI：
10.1097/scs.0000000000002529
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发表时间：
2016
影响因子：
0.9
通讯作者：
I. Pan
中科院分区：
文献类型：
--
作者：
S. Lam;J. Fridley;V. Desai;V. Srinivasan;A. Jea;T. Luerssen;I. Pan
摘要 美国外科医生学会和美国儿科外科协会通过儿科国家外科质量改进计划 (NSQIP Peds) 合作，为儿科医院提供多专科手术结果数据。作者使用这个国家多中心数据库描述了颅缝早闭手术的 30 天结果，并确定了与围手术期事件和输血的关联。 NSQIP Ped 的数据用于描述接受颅缝早闭手术的儿童。作者检查了临床危险因素与围手术期并发症和输血的明确终点结果的统计关联。其中包括五百七十二例手术。根据通用程序术语代码，93 例被确定为单缝线粘连，其余为多处或未知缝线受累。未捕获受影响缝线的位置。平均手术时间为 196.84 分钟 (SD 113.46)。平均住院时间为 4.22 天 (SD 5.04)。百分之六十七的患者接受了输血。 3.15% 是其他围手术期事件，包括感染、伤口破裂、意外重新插管、中风/出血、心脏骤停、癫痫发作、血栓栓塞。 2.8% 重新入院； 2.45%在30天内接受了再次手术。有输血与无输血的情况下，手术持续时间和住院时间有显着差异。多因素分析显示，麻醉开始到手术开始的时间、手术结束到麻醉结束的时间、手术持续时间是输血的危险因素。儿科 NSQIP 提供了全国颅缝早闭手术 30 天结果指标的概述。围手术期不良事件发生率为3.15%。手术时间和麻醉时间与输血显着相关。作者确定了儿科 NSQIP 数据库改进的机会。
Abstract The American College of Surgeons and the American Pediatric Surgical Association collaborate to provide pediatric hospitals with multispeciality surgical outcomes data through the Pediatric National Surgical Quality Improvement Program (NSQIP Peds). The authors used this national multicenter database to describe 30-day outcomes from craniosynostosis surgery and identify associations with perioperative events and blood transfusion. Data from NSQIP Peds were used to describe children undergoing craniosynostosis surgery. The authors examined statistical association of clinical risk factors with the defined end point outcomes of perioperative complications and blood transfusion. Five hundred seventy-two surgeries were included. By Common Procedural Terminology codes, 93 identified as single suture synostosis, the remainder as multiple or unknown suture involvement. Location of the affected suture is not captured. Mean surgical time was 196.84 minutes (SD 113.46). Mean length of stay was 4.22 days (SD 5.04). Sixty-seven percent of patients received blood transfusions. 3.15% were other perioperative occurrences, including infection, wound disruption, unplanned reintubation, stroke/hemorrhage, cardiac arrest, seizures, thromboembolism. 2.8% were readmitted; 2.45% underwent reoperation within 30 days. Duration of surgery and length of hospital stay significantly differed in the presence of blood transfusion versus none. On multivariate analysis, duration from anesthesia start to surgery start, duration from surgery end to anesthesia end, and duration of operation were risk factors for blood transfusion. Pediatric NSQIP gives a national overview of 30-day outcome metrics in craniosynostosis surgery. Perioperative adverse event rate was 3.15%. Duration of surgery and duration of anesthesia were significantly associated with blood transfusion. The authors identified opportunities for pediatric NSQIP database improvement.
颅缝早闭的手术治疗：250 名连续患者的结果分析。
影响因子：
8
作者：
Sloan,GM;Wells,KC;Raffel,C;McComb,JG
通讯作者：
McComb,JG