Effect of physician specialty training on pediatric appendectomy outcomes: an NSQIP-P analysis.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-11-10 DOI:10.1007/s00383-024-05891-x

Eli M Snyder, Maveric K Abella, Ivana J Yoon, Anson Y Lee, Sneha A Singh, Cameron J Harvey, Devin P Puapong, Russell K Woo

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引用次数: 0

Abstract

Purpose: Appendectomies are the most common abdominal emergency surgery in pediatric patients. Both pediatric and general surgeons are credentialed to perform this procedure, however pediatric surgeons are specialized in pediatrics. This study seeks to determine differences in pediatric appendectomy outcomes between general and pediatric surgeons.

Methods: Pediatric patients undergoing appendectomies between 2015 and 2020 were identified in the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. Multivariable logistic regression models examined association of surgeon specialty with readmission, postoperative complications, reoperation, non-home discharge destination, operative time, etc. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated.

Results: Average ages of pediatric patients undergoing appendectomy by pediatric and general surgeons were 11.2 (n = 68,638) and 12.3 (n = 3,986) years, respectively (p < .001). General surgeons were not more likely to have adverse outcomes [AOR: 1.00 (0.99-1.01), p = 0.57], readmissions [AOR: 0.995 (0.98-1.00), p = 0.11], reoperations [AOR: 1.00 (0.99-1.00), p = 0.54], or non-home discharges [AOR: 0.99 (0.99-1.00), p = 0.94].

Conclusions: Similar outcomes arise in pediatric appendectomies performed by general surgery at a children's hospital or hospitals with a pediatric wing. Significant limitations to using the NSQIP-P database persist. Further research including hospitals contributing to both adult and pediatric databases can provide a clearer picture of post-surgical outcomes in appendectomies.

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医生专科培训对小儿阑尾切除术结果的影响：NSQIP-P 分析。

目的：阑尾切除术是儿科病人最常见的腹部急诊手术。小儿外科医生和普通外科医生都有资格进行这种手术，但小儿外科医生专攻儿科。本研究旨在确定普外科医生和小儿外科医生在小儿阑尾切除术结果上的差异：在国家外科质量改进计划儿科（NSQIP-P）数据库中确定了2015年至2020年间接受阑尾切除术的小儿患者。多变量逻辑回归模型检验了外科医生专业与再入院、术后并发症、再次手术、非家庭出院目的地、手术时间等的相关性。计算了调整后的几率比（AOR）和 95% 的置信区间（CI）：结果：由小儿外科医生和普通外科医生进行阑尾切除术的小儿患者平均年龄分别为 11.2 岁（n = 68,638 人）和 12.3 岁（n = 3,986 人）（p 结论：小儿阑尾切除术和普通阑尾切除术的结果相似：在儿童医院或设有儿科病房的医院由普外科医生进行小儿阑尾切除术的结果相似。使用 NSQIP-P 数据库仍有很大的局限性。进一步的研究（包括向成人和儿科数据库提供数据的医院）可以更清楚地了解阑尾切除术的术后效果。

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