Hyuksool Kwon1, Jin Hee Lee2, Jin Hee Jeong3, Hye Ran Yang4, Young Ho Kwak2, Do Kyun Kim2, Kyuseok Kim1. 1. From the Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang, Seongnam, Gyeonggi. 2. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul. 3. Department of Emergency Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam. 4. Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Bundang, Seongnam, Gyeonggi, Republic of Korea.
Abstract
OBJECTIVES: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence. METHODS: We developed a practice guideline of postreduction management of intussusception in the PED. The practice guideline involved feeding 2 hours after reduction and discharge 2 hours after successful feeding. The guideline was implemented on October 1, 2012. Retrospective quasi-experimental study was conducted for evaluation of the difference in LOS in the PED after reduction of intussusceptions, and the recurrence rate of intussusceptions between the preimplementation and postimplementation periods. Piecewise regression was performed to determine the differences between groups. RESULTS: In total, 45 and 52 patients were included in the preimplementation and postimplementation periods, respectively. The median LOS in the postimplementation period was significantly shorter than that in the preimplementation period (289 vs 532 minutes, respectively; P = 0.001). The slope of the LOS changed from 0.68 to -0.29. The slope decreased by 0.97 after practice guideline implementation. This difference was not statistically significant (P = 0.123), but it changed from a positive to negative gradient. The recurrence rate was not significantly different between the 2 periods (P = 0.605). CONCLUSIONS: Implementation of a practice guideline involving early feeding and discharge after reduction of intussusception resulted in a reduced LOS from reduction of intussusception in the PED and was not associated with recurrence of intussusception.
OBJECTIVES: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence. METHODS: We developed a practice guideline of postreduction management of intussusception in the PED. The practice guideline involved feeding 2 hours after reduction and discharge 2 hours after successful feeding. The guideline was implemented on October 1, 2012. Retrospective quasi-experimental study was conducted for evaluation of the difference in LOS in the PED after reduction of intussusceptions, and the recurrence rate of intussusceptions between the preimplementation and postimplementation periods. Piecewise regression was performed to determine the differences between groups. RESULTS: In total, 45 and 52 patients were included in the preimplementation and postimplementation periods, respectively. The median LOS in the postimplementation period was significantly shorter than that in the preimplementation period (289 vs 532 minutes, respectively; P = 0.001). The slope of the LOS changed from 0.68 to -0.29. The slope decreased by 0.97 after practice guideline implementation. This difference was not statistically significant (P = 0.123), but it changed from a positive to negative gradient. The recurrence rate was not significantly different between the 2 periods (P = 0.605). CONCLUSIONS: Implementation of a practice guideline involving early feeding and discharge after reduction of intussusception resulted in a reduced LOS from reduction of intussusception in the PED and was not associated with recurrence of intussusception.
Authors: Lorraine I Kelley-Quon; L Grier Arthur; Regan F Williams; Adam B Goldin; Shawn D St Peter; Alana L Beres; Yue-Yung Hu; Elizabeth J Renaud; Robert Ricca; Mark B Slidell; Amy Taylor; Caitlin A Smith; Doug Miniati; Juan E Sola; Patricia Valusek; Loren Berman; Mehul V Raval; Ankush Gosain; Matthew B Dellinger; Stig Sømme; Cynthia D Downard; Jarod P McAteer; Akemi Kawaguchi Journal: J Pediatr Surg Date: 2020-10-06 Impact factor: 2.545
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