Is NSQIP Pediatric review representative of total institutional experience for children undergoing appendectomy?
Is NSQIP Pediatric review representative of total institutional experience for children undergoing appendectomy?
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DOI：
10.1016/j.jpedsurg.2013.10.007
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发表时间：
2014-08-01
影响因子：
2.4
通讯作者：
Blakely, Martin L.
中科院分区：
文献类型：
--
作者：
Duggan, Eileen M.;Gates, Dan W.;Blakely, Martin L.
背景/目的：NSQIP儿科(NSQIP-P)是一项强有力的质量改进努力。NSQIP程序的局限性在于只能捕获总案件数量的一小部分。这项研究检验了NSQIP-P捕获的阑尾切除术是否与2011年最常见的阑尾切除手术一致。方法：我们比较了2011年在一家三级转诊儿童医院接受阑尾切除术的儿童(n=80)和未被NSQIP捕获的儿童(n=276)的病例组合和30天的预后。结果：NSQIP-P收集了356例阑尾切除手术中的80例(22%)。NSQIP组和非NSQIP组之间的病例组合相似(例如，每组中31%的人患有复杂的阑尾炎)。结果也相似：术后发生率为7.5%比7.6%，再入院率为5%比4.7%，回到手术室的比率为3.8%比4.3%。结论：尽管NSQIP-P涵盖了少数接受阑尾切除术的患者，但病例组合和结果相似。我们的结果提供了保证，NSQIP-P数据代表了这一程序的更大人群。这种一致性是否存在于较少执行的程序中尚不清楚，也是正在进行的工作的重点。(C)2014 Elsevier Inc.保留所有权利。
Background/purpose: NSQIP Pediatric (NSQIP-P) is a robust quality improvement effort. A limitation of the NSQIP process lies in capturing a small proportion of the total case volume. This study examines whether appendectomies captured by NSQIP-P are concordant with all appendectomies, the most commonly captured procedure in 2011.Methods: We compared case mix and 30-day outcomes between children undergoing an appendectomy who were included in NSQIP (n = 80) and children not captured by NSQIP (n = 276) during 2011 at a tertiary referral children's hospital. A single surgical case reviewer reviewed all cases using NSQIP-P methodology.Results: NSQIP-P captured 80 of a total of 356 appendectomies (22%). The case mix was similar between NSQIP and non-NSQIP groups (e.g., 31% of each group had complicated appendicitis). Outcomes were also similar; post-operative occurrences, readmissions and return to the operation room occurred at rates of 7.5% vs. 7.6%, 5% vs. 4.7%, and 3.8% vs. 4.3% respectively.Conclusion: Although NSQIP-P captured a minority of the total patient population that had an appendectomy, the case mix and outcomes were similar. Our results offer reassurance that NSQIP-P data are representative of the larger population for this procedure. Whether this concordance exists for procedures less commonly performed is unknown and a focus of ongoing work. (C) 2014 Elsevier Inc. All rights reserved.