Outcomes in pediatric surgery by hospital volume: a population-based comparison

LaRiviere, Cabrini A.; McAteer, Jarod P.; Huaco, Jorge A.; Garrison, Michelle M.; Avansino, Jeffrey R.; Oldham, Keith T.; Goldin, Adam B.

doi:10.1007/s00383-013-3293-9

Cited by 15 publications

(6 citation statements)

References 28 publications

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Section: Discussionsupporting

confidence: 70%

“…The low readmission rates seen in our study closely track readmission rates in other pediatric surgical populations: 2.6% in pediatric general surgery and 3.5% in pediatric urology patients. 16,17 Although the global pediatric ENT readmission rate was relatively low, there was a range of readmission rates that varied between each procedure group (Table 1). It is likely that certain procedural types (e.g., HN) will include patients with disproportionately burdensome comorbid conditions, and this may explain some of the variation.…”

Section: Not All Ent Procedures Types Are Equivalent In Readmissionsmentioning

confidence: 99%

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Frequency and cause of readmissions following pediatric otolaryngologic surgery

2015

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Readmissions after pediatric otolaryngologic surgery are relatively uncommon. These readmission rates vary directly with the type of procedure performed, as well as patient level factors (i.e., patient age, ethnicity, and the presence of other medical comorbidities). These data demonstrate that if readmission rates are to be used as a quality measure in pediatric otolaryngology procedures, complex risk adjustment of patient level variables will be necessary to accurately compare outcomes between different hospitals.

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Section: Discussionsupporting

confidence: 70%

Section: Not All Ent Procedures Types Are Equivalent In Readmissionsmentioning

confidence: 99%

Frequency and cause of readmissions following pediatric otolaryngologic surgery

2015

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“…Of those, 1082 records were excluded after screening for inappropriate article type; only randomized control trials and review articles were included, and those reporting key outcomes; 675 full text articles were then assessed for eligibility and 598 were excluded due to data being either inadequate for data interpretation, relating to interval appendectomy or duplication of studies. 77 were found to meet the inclusion criteria, and 45 of these were included for analysis after applying the MINORS score cut off . The modified PRISMA flowchart for identification and inclusion of relevant papers is included as Appendix S1.…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of unplanned readmission to hospital post‐appendectomy: an opportunity for a new benchmark

Bailey

Choynowski

Kabir

et al. 2019

ANZ Journal of Surgery

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Background Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention. While many studies report readmission, a meta‐analysis of readmission post‐appendectomy has not been published. This meta‐analysis was undertaken to determine rates and predictors of hospital readmission following appendectomy and to potentially provide a metric benchmark. Methods An ethically approved PROSPERO‐registered (ID CRD42017069040) meta‐analysis following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, using databases PubMed and Scopus, was undertaken for studies published between January 2012 and June 2017. Articles relating to outcomes and readmissions after appendectomy were identified. Those scoring >15 for comparative studies and >10 for non‐comparative studies, using Methodological Index for Non‐Randomized Studies criteria were included in the final analysis. The odds ratios (OR) using random‐effects, Mantel–Haenszel method with 95% confidence intervals (CI), were computed for each risk factor with RevMan5. Results A total of 1757 articles reviewed were reduced to 45 qualifying studies for a final analysis of 836 921 appendectomies. 4.3% (range 0.0–14.4%) of patients were readmitted within 30 days. Significant preoperative patient factors for increased readmission were diabetes mellitus (OR 1.93, CI 1.63–2.28, P < 0.00001), complicated appendicitis (OR 3.6, CI 2.43–5.34, P < 0.00001) and open surgical technique (OR 1.39, CI 1.08–1.79, P < 0.00001). Increased readmission was not associated with gender, obesity or paediatric versus general surgeons or centres. Conclusion This meta‐analysis identified that readmission is not uncommon post‐appendectomy, occurring in one in 25 cases. The mean readmission rate of 4.3% may act as a quality benchmark for improving emergency surgical care. Targeting high‐risk groups with diabetes or complicated appendicitis and increasing use of laparoscopic technique may help reduce readmission rates.

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“…[17][18][19][20][21][22][23] It is thought that hospital level variation can be partly explained by differences in patient characteristics from hospital to hospital, and by an inverse relationship between hospital volume and perioperative morbidity and mortality. [24][25][26][27] In this study we use data from the international ALPPS registry to estimate the range of possible perioperative outcomes, the expected improvements over time, and the role that ALPPS volume plays in influencing patient outcomes.…”

Section: Introductionmentioning

confidence: 99%