Alexander C Ednie1, Ofer Amram2, Nadine Schuurman2, Natalie L Yanchar3. 1. Dalhousie University, Division of General Surgery, QEII Health Sciences Centre, 8-813 VG Site, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada. Electronic address: acednie@gmail.com. 2. Simon Fraser University, Department of Geography, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. 3. Dalhousie University, Division of General Surgery, QEII Health Sciences Centre, 8-813 VG Site, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada; IWK Health Centre, Division of Pediatric Surgery, 5980 University Ave, Halifax, NS, B3K 6R8, Canada.
Abstract
BACKGROUND: Changing patterns of referral and management of hypertrophic pyloric stenosis (HPS) in North America have recently been described. Comfort with perioperative management, anesthesia, and corrective surgery have been cited as reasons for these changes. Our primary objective was to assess pyloromyotomy outcomes between different hospital types across Canada. The secondary objective was to geospatially map all pyloromyotomies to identify regions of higher HPS incidence across Canada. METHODS: Data of all pyloromyotomies done between 2011 and 2013 were acquired from Canadian Institute for Health Information (CIHI). Complication rates and length of hospital stay (LOS) were analyzed. Postal codes for each patient were used to geospatially map regions of higher HPS incidence. RESULTS: A total of 1261 pyloromyotomies were assessed. There was no difference in LOS or complication rates between different hospital types or surgeon group. Open pyloromyotomies were done in 75% of the cases. Several regions of higher HPS incidence were identified across Canada. CONCLUSION: This study found no difference in complication rate or LOS stay between hospital type and surgeon type across Canada. This may reflect a previously identified referral trend in the United States towards pediatric centers. Several regions of higher HPS incidence were identified, and may aid in identifying genetic elements causing HPS. LEVEL OF EVIDENCE: 2c. Crown
BACKGROUND: Changing patterns of referral and management of hypertrophic pyloric stenosis (HPS) in North America have recently been described. Comfort with perioperative management, anesthesia, and corrective surgery have been cited as reasons for these changes. Our primary objective was to assess pyloromyotomy outcomes between different hospital types across Canada. The secondary objective was to geospatially map all pyloromyotomies to identify regions of higher HPS incidence across Canada. METHODS: Data of all pyloromyotomies done between 2011 and 2013 were acquired from Canadian Institute for Health Information (CIHI). Complication rates and length of hospital stay (LOS) were analyzed. Postal codes for each patient were used to geospatially map regions of higher HPS incidence. RESULTS: A total of 1261 pyloromyotomies were assessed. There was no difference in LOS or complication rates between different hospital types or surgeon group. Open pyloromyotomies were done in 75% of the cases. Several regions of higher HPS incidence were identified across Canada. CONCLUSION: This study found no difference in complication rate or LOS stay between hospital type and surgeon type across Canada. This may reflect a previously identified referral trend in the United States towards pediatric centers. Several regions of higher HPS incidence were identified, and may aid in identifying genetic elements causing HPS. LEVEL OF EVIDENCE: 2c. Crown