Trends and outcomes in pediatric laparoscopic appendectomy: a NSQIP-P analysis of same-day discharge and readmission rates.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-11-02 DOI:10.1007/s00383-024-05869-9

John M Woodward, Stephanie F Brierley, Krystle Bittner, Katherine Foote, Hector Osei, Carroll M Harmon, P Benson Ham Iii

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引用次数: 0

Abstract

Purpose: Practice patterns of same-day discharge for pediatric laparoscopic appendectomy for non-perforated appendicitis are not well-analyzed. Our aim is to evaluate current practice patterns and outcomes of same-day discharge for these patients.

Methods: NSQIP-P retrospective registry identified patients (2017-2021) who underwent laparoscopic appendectomy for non-perforated appendicitis. Annual same-day discharge (SDD) rate was determined. SDD patients were compared to those discharged postoperative days 1-2 (non-SDD). Sub-group analysis was performed on ICD-10 code K35.30. Regression was performed.

Results: Overall, 67,214 patients were identified. The SDD rate increased from 33.3% (2017) to 52.5% (2021) with decreased 30-day readmissions between SDD and non-SDD (1.3% vs 2.1%, p < 0.001). Sub-group analysis identified 7,330 patients with SDD rates from 50.7% (2019) to 60.4% (2021) with decreased 30-day readmissions (1.3% vs 2.1%, p < 0.001) for SDD versus non-SDD. No increase in adverse events for SDD occurred in either analysis. Regression identified esophageal/gastric/intestinal diseases increased odds of early readmission or reoperation (OR 1.85, p = 0.042).

Conclusion: Same-day discharge after pediatric laparoscopic appendectomy for non-perforated acute appendicitis continues to increase in frequency without a significant increase in adverse outcomes. SDD rates are 20-30% lower than previously published single-center studies, indicating there is a likely a larger percentage of patients that could discharge same-day.

Level of evidence (i-v): Level III.

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小儿腹腔镜阑尾切除术的趋势和结果：NSQIP-P 对当天出院率和再入院率的分析。

目的：小儿腹腔镜阑尾切除术治疗非穿孔性阑尾炎的当日出院实践模式尚未得到充分分析。我们的目的是评估目前这些患者当天出院的实践模式和结果：NSQIP-P回顾性登记册确定了（2017-2021年）接受腹腔镜阑尾切除术治疗非穿孔性阑尾炎的患者。确定了年度当日出院率（SDD）。将 SDD 患者与术后第 1-2 天出院的患者（非 SDD）进行比较。根据 ICD-10 代码 K35.30 进行分组分析。结果：结果：共发现 67,214 名患者。SDD率从33.3%（2017年）上升至52.5%（2021年），SDD与非SDD的30天再入院率有所下降（1.3% vs 2.1%，P 结论：SDD率从33.3%（2017年）上升至52.5%（2021年），SDD与非SDD的30天再入院率有所下降：小儿腹腔镜阑尾切除术治疗非穿孔性急性阑尾炎后当天出院的频率继续增加，但不良后果并未显著增加。SDD率比之前发表的单中心研究低20%-30%，表明可能有更大比例的患者可以当天出院：III级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor