Comparison of childhood appendicitis management in the regional paediatric surgery unit and the district general hospital

Collins, Hannah L.; Almond, Sarah; Thompson, Ben; Lacy, David; Greaney, M. G.; Baillie, Colin; Kenny, Simon E.

doi:10.1016/j.jpedsurg.2009.10.079

Cited by 24 publications

(19 citation statements)

References 4 publications

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“…2 and 3). Other results found lower complication rates in patients treated by specialists [15,17] (Fig. 3).…”

Section: Complication Ratesmentioning

confidence: 79%

“…2 and 3), but Fig. 5 shows some increases if treated in a general hospital compared with a tertiary center [16,17].…”

Section: Readmission Ratesmentioning

confidence: 95%

“…Overall, specialist surgeons and high-volume centers were more accurate in diagnosing appendicitis (lower rates of negative appendicectomy), although the differences were small [13][14][15][16][17][18][19] (Figs. 2, 3, 5, and 6).…”

Section: Misdiagnosis Of Appendicitis (Negative Appendicectomy Rate)mentioning

confidence: 99%

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The effect of surgical training and hospital characteristics on patient outcomes after pediatric surgery: a systematic review

Evans

Woerden

2011

Journal of Pediatric Surgery

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“…2 and 3). Other results found lower complication rates in patients treated by specialists [15,17] (Fig. 3).…”

Section: Complication Ratesmentioning

confidence: 79%

“…2 and 3), but Fig. 5 shows some increases if treated in a general hospital compared with a tertiary center [16,17].…”

Section: Readmission Ratesmentioning

confidence: 95%

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The effect of surgical training and hospital characteristics on patient outcomes after pediatric surgery: a systematic review

Evans

Woerden

2011

Journal of Pediatric Surgery

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“…2 Shock due to anesthesia T88. 3 Malignant hyperthermia due to anesthesia T88. 4 Failed intubation T88.…”

Section: Appendixmentioning

confidence: 99%

“…[1][2][3] Reducing numbers of emergency appendectomy procedures carried out in children have further raised concerns about the quality and safety of care in district general hospitals (DGHs) compared with specialist units in England. 4 Acute appendicitis is the most common surgical emergency in children, with a lifetime risk of 7% to 8% and an incidence of up to 20 to 30 cases per 10,000 children per year between 10 and 17 years of age.…”

mentioning

confidence: 99%

Pediatric Emergency Appendectomy and 30-Day Postoperative Outcomes in District General Hospitals and Specialist Pediatric Surgical Centers in England, April 2001 to March 2012

et al. 2016

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Influence of Surgeon Experience, Hospital Volume, and Specialty Designation on Outcomes in Pediatric Surgery

McAteer¹,

LaRiviere²,

Drugas³

et al. 2013

JAMA Pediatr

125

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Importance: Analyses of volume-outcome relationships in adult surgery have found that hospital and physician characteristics affect patient outcomes, such as length of stay, hospital charges, complications, and mortality. Similar investigations in children's surgical specialties are fewer in number, and their conclusions are less clear.Objective: To review the evidence regarding surgeon or hospital experience and their influence on outcomes in children's surgery.Evidence Review: A MEDLINE and EMBASE search was conducted for English-language studies published from January 1, 1980, through April 13, 2012. Titles and abstracts were screened in a standardized manner by 2 reviewers. Studies selected for inclusion had to use a measure of hospital or surgeon experience as a predictor variable and had to report postoperative outcomes as dependent response variables. Included studies were reviewed with regard to methodologic quality, and study results were extracted.Findings: Sixty-three studies were reviewed. Significant heterogeneity was detected in exposure definitions, outcome measures, and risk adjustment, with the greatest heterogeneity seen in appendectomy studies. Various exposure levels were examined: hospital level in 48 (68%) studies, surgeon level in 11 (17%), and both in 9 (14%). Nineteen percent of studies did not adjust for confounding, and 57% did not adjust for sample clustering. The most consistent methods and reproducible results were seen in the pediatric cardiac surgical literature. Forty-nine studies (78%) showed positive correlation between experience and most primary outcomes, but differences in outcomes and exposure definitions made comparisons between studies difficult. In general, hospital-level factors tended to correlate with outcomes for high-complexity procedures, whereas surgeon-level factors tended to correlate with outcomes for more common procedures.Conclusions and Relevance: Data on experiencerelated outcomes in children's surgery are limited in number and vary widely in methodologic quality. Future studies should seek both to standardize definitions, making results more applicable, and to differentiate procedures affected by surgeon experience from those more affected by hospital resources and system-level variables.

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Comparison of childhood appendicitis management in the regional paediatric surgery unit and the district general hospital

Cited by 24 publications

References 4 publications

The effect of surgical training and hospital characteristics on patient outcomes after pediatric surgery: a systematic review

The effect of surgical training and hospital characteristics on patient outcomes after pediatric surgery: a systematic review

Pediatric Emergency Appendectomy and 30-Day Postoperative Outcomes in District General Hospitals and Specialist Pediatric Surgical Centers in England, April 2001 to March 2012

Influence of Surgeon Experience, Hospital Volume, and Specialty Designation on Outcomes in Pediatric Surgery

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