TY - JOUR
T1 - Pediatric American College of Surgeons National Surgical Quality Improvement Program
T2 - Feasibility of a novel, prospective assessment of surgical outcomes
AU - Raval, Mehul V.
AU - Dillon, Peter W.
AU - Bruny, Jennifer L.
AU - Ko, Clifford Y.
AU - Hall, Bruce L.
AU - Moss, R. Lawrence
AU - Oldham, Keith T.
AU - Richards, Karen E.
AU - Vinocur, Charles D.
AU - Ziegler, Moritz M.
N1 - Funding Information:
MVR participates in the American College of Surgeons Clinical Scholars in Residence Program. MVR is supported by the John Gray Research Fellowship and the Daniel F. and Ada L. Rice Foundation. The authors would like to thank the ACS NSQIP staff and the tremendous efforts toward high-quality, accurate data collection by the ACS NSQIP SCRs.
PY - 2011/1
Y1 - 2011/1
N2 - Purpose: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides validated assessment of surgical outcomes. This study reports initiation of an ACS NSQIP Pediatric at 4 children's hospitals. Methods: From October 2008 to June 2009, 121 data variables were prospectively collected for 3315 patients, including 30-day outcomes and tailoring the ACS NSQIP methodology to children's surgical specialties. Results: Three hundred seven postoperative complications/occurrences were detected in 231 patients representing 7.0% of the study population. Of the patients with complications, 175 (75.7%) had 1, 39 (16.9%) had 2, and 17 (7.4%) had 3 or more complications. There were 13 deaths (0.39%) and 14 intraoperative occurrences (0.42%) detected. The most common complications were infection, 105 (34%) (SSI, 54; sepsis, 31; pneumonia, 13; urinary tract infection, 7); airway/respiratory events, 27 (9%); wound disruption, 18 (6%); neurologic events, 8 (3%) (nerve injury, 4; stroke/vascular event, 2; hemorrhage, 2); deep vein thrombosis, 3 (<1%); renal failure, 3 (<1%); and cardiac events, 3 (<1%). Current sampling captures 17.5% of cases across institutions with unadjusted complication rates ranging from 6.8% to 10.2%. Completeness of data collection for all variables exceeded 95% with 98% interrater reliability and 87% of patients having full 30-day follow-up. Conclusion: These data represent the first multiinstitutional prospective assessment of specialty-specific surgical outcomes in children. The ACS NSQIP Pediatric is poised for institutional expansion and future development of risk-adjusted models.
AB - Purpose: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides validated assessment of surgical outcomes. This study reports initiation of an ACS NSQIP Pediatric at 4 children's hospitals. Methods: From October 2008 to June 2009, 121 data variables were prospectively collected for 3315 patients, including 30-day outcomes and tailoring the ACS NSQIP methodology to children's surgical specialties. Results: Three hundred seven postoperative complications/occurrences were detected in 231 patients representing 7.0% of the study population. Of the patients with complications, 175 (75.7%) had 1, 39 (16.9%) had 2, and 17 (7.4%) had 3 or more complications. There were 13 deaths (0.39%) and 14 intraoperative occurrences (0.42%) detected. The most common complications were infection, 105 (34%) (SSI, 54; sepsis, 31; pneumonia, 13; urinary tract infection, 7); airway/respiratory events, 27 (9%); wound disruption, 18 (6%); neurologic events, 8 (3%) (nerve injury, 4; stroke/vascular event, 2; hemorrhage, 2); deep vein thrombosis, 3 (<1%); renal failure, 3 (<1%); and cardiac events, 3 (<1%). Current sampling captures 17.5% of cases across institutions with unadjusted complication rates ranging from 6.8% to 10.2%. Completeness of data collection for all variables exceeded 95% with 98% interrater reliability and 87% of patients having full 30-day follow-up. Conclusion: These data represent the first multiinstitutional prospective assessment of specialty-specific surgical outcomes in children. The ACS NSQIP Pediatric is poised for institutional expansion and future development of risk-adjusted models.
KW - ACS NSQIP
KW - Outcomes
KW - Pediatric surgery
KW - Quality assessment
UR - http://www.scopus.com/inward/record.url?scp=78751482296&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2010.09.073
DO - 10.1016/j.jpedsurg.2010.09.073
M3 - Article
C2 - 21238651
AN - SCOPUS:78751482296
SN - 0022-3468
VL - 46
SP - 115
EP - 121
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 1
ER -