Literature DB >> 30414692

Room for "quality" improvement? Validating National Surgical Quality Improvement Program-Pediatric (NSQIP-P) appendectomy data.

Kathryn T Anderson1, Marisa A Bartz-Kurycki1, Mary T Austin2, Akemi L Kawaguchi2, Lillian S Kao1, Kevin P Lally2, KuoJen Tsao3.   

Abstract

INTRODUCTION: Accurate data are essential for the validity of clinical registries. This study aimed to validate NSQIP-P data, assess representativeness, and evaluate risk-adjusted predictive ability at a single institution.
METHODS: A prospective appendectomy-specific pediatric surgery research database (RD) maintained by clinical researchers was compared to the NSQIP-P data for appendectomies performed in 2016 at a tertiary children's hospital. NSQIP-P sampled data collected by trained surgical clinical reviewers (SCRs) were compared to matched RD patients. Both datasets used NSQIP-P definitions. Using χ2, datasets were compared by patient demographics, disease severity (simple vs. complicated), and outcomes.
RESULTS: 458 appendectomies for acute appendicitis were performed in 2016, of which 250 (55%) were abstracted by SCRs and matched to RD patients. Patient demographics were similar between datasets. Disease severity (NSQIP-P:50% complicated vs RD:31% complicated) and composite morbidity (NSQIP-P:6.0% vs RD:14.4%) were significantly different (both p < 0.01). Demographics and outcomes were similar between matched (n = 250) and unsampled patients in the RD (n = 208). NSQIP-P's risk-adjusted predicted morbidity was significantly lower than morbidity observed in all (n = 458) RD patients (NSQIP-P:9.9% vs RD:14.2%, p < 0.01).
CONCLUSIONS: Though constituting a representative sample, NSQIP-P appendectomy data were inconsistent with department data. Discrepancies appear to be the result of underreporting of outcome variables and disease misclassification. TYPE OF STUDY: Retrospective comparative review. LEVEL OF EVIDENCE: Level III.
Copyright © 2018 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Appendectomy; Databases; NSQIP; Outcome assessment; Pediatric; Quality improvement

Mesh:

Year:  2018        PMID: 30414692     DOI: 10.1016/j.jpedsurg.2018.10.017

Source DB:  PubMed          Journal:  J Pediatr Surg        ISSN: 0022-3468            Impact factor:   2.545


  2 in total

1.  Incidence of Readmission Following Pediatric Hand Surgery: An Analysis of 6600 Patients.

Authors:  Christopher J Goodenough; Cassie A Hartline; Shuyan Wei; Joseph K Moffitt; Alfredo Cepeda; Phuong D Nguyen; Matthew R Greives
Journal:  Eplasty       Date:  2022-09-07

2.  Management of pediatric appendicitis during the COVID-19 pandemic: A nationwide multicenter cohort study.

Authors:  Brittany Hegde; Elisa Garcia; Andrew Hu; Mehul Raval; Sanyu Takirambudde; Derek Wakeman; Ruth Lewit; Ankush Gosain; Raphael H Parrado; Robert A Cina; Krista Stephenson; Melvin S Dassinger; Daniel Zhang; Moiz M Mustafa; Donna Koo; Aaron M Lipskar; Katherine Scheidler; Kyle J Van Arendonk; Patrick Berg; Raquel Gonzalez; Daniel Scheese; Jeffrey Haynes; Alexander Mina; Irving J Zamora; Monica E Lopez; Steven C Mehl; Elizabeth Gilliam; Katrina Lofberg; Brianna Spencer; Afif N Kulaylat; Brian C Gulack; Matthew Johnson; Matthew Laskovy; Pavan Brahmamdam; Aoi Shimomura; Therese Blanch; KuoJen Tsao; Bethany J Slater
Journal:  J Pediatr Surg       Date:  2022-08-13       Impact factor: 2.549

  2 in total

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