Contemporary Trends in Surgical Correction of Pediatric Ureteropelvic Junction Obstruction: Data From the Nationwide Inpatient Sample

Abstract

Practice patterns in pediatric pyeloplasty evolved between 1988 and 2000. Fewer procedures are being performed in newborns, suggesting that patients with prenatal hydronephrosis are increasingly being observed instead of undergoing early surgery. There was a substantial difference in timing of surgery between whites and nonwhites. To our knowledge this observation has not previously been reported. More procedures are being performed at teaching hospitals, and length of stay has decreased significantly.

Factors associated with age at pyeloplasty in children with ureteropelvic junction obstruction

“…We found that non-clinical patient factors were associated with timing of surgery in children with UPJ obstruction independent of severity of disease. Our study confirms prior studies that have shown a racial difference in age at surgery [4]. Unlike prior studies where the median age at surgery was 3 years of age or older, we found that the median age at surgery in our sample was less than 1 year of age.…”

“…Unlike prior studies where the median age at surgery was 3 years of age or older, we found that the median age at surgery in our sample was less than 1 year of age. This may in part be due to our use of both diagnosis codes and procedure codes to identify patients with congenital UPJ obstruction undergoing pyeloplasty rather than use of procedure codes alone [3,4].…”

“…The benefits of early diagnosis and treatment, however, may not be equally distributed among children of different racial backgrounds. Unlike appendectomy, where nonwhite children are less likely to undergo timely intervention [2], nonwhite children have been observed to be more likely to undergo early pyeloplasty than their white, non-Hispanic counterparts [3,4].…”

Race and 30-Day Morbidity in Pediatric Urologic Surgery

“…However, race has not been previously well examined as a predictor of outcomes in pediatric urology, with studies either excluding race from their analyses 38 for unclear 6 reasons or being limited, by the data sets used, to exploring associations with timing of surgery rather than with complications. [39][40][41] Additionally, multiple risk score nomograms in the pediatric surgery literature did not specifically assess race as a predictor of outcomes, [42][43][44] which highlights the clinical importance of our finding.…”

Acurária do estudo dos jatos ureterais à ultra-sonografia do Doppler Colorido no diagnóstico das hidronefroses

“…O sistema coletor e os ureteres dos fetos não são observados em condições normais à ultra-sonografia. Quando o são, considera-se a unidade como hidronefrótica (Nelson et al, 2005).…”