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30-day readmission after pediatric upper extremity surgery: Analysis of the NSQIP database
Stephanie Thibaudeau1, Jason B Anari1, Nicholas Carducci2
1University of Pennsylvania, Department of Orthopaedic Surgery, Philadelphia, PA.
Insights
Pediatric upper extremity surgery is safe, with low rates of complications and readmissions. Focusing on surgical site infections and complex medical conditions can further improve outcomes.
Area of Science:
- Pediatric Surgery
- Orthopedic Surgery
- Health Services Research
Background:
- Pediatric upper extremity surgery is common.
- Understanding complication and readmission rates is crucial for patient safety and healthcare quality.
Purpose of the Study:
- To determine the incidence and risk factors for complications, reoperations, and 30-day unplanned readmissions following pediatric upper extremity surgery.
- To identify patient- and surgery-related factors influencing adverse outcomes.
Main Methods:
- Retrospective analysis of the 2013 National Surgery Quality Improvement Program (NSQIP) pediatric database.
- Identification of procedures using CPT codes for primary upper extremity procedures.
- Univariate and multivariate analyses to identify risk factors.
Main Results:
- Low overall rates of complications (1.70%), reoperations (0.5%), and readmissions (0.78%) were observed.
- Factors associated with increased readmission included reoperation, inpatient procedures, surgical site infection, and complex medical histories (cardiac, gastrointestinal, pulmonary, CNS disorders).
Conclusions:
- Pediatric upper extremity surgery demonstrates a favorable safety profile with low complication and readmission rates.
- Strategies to reduce surgical site infections and manage complex pediatric medical conditions may further decrease adverse events.
Purpose:
To determine the incidence and risk factors of complications, reoperations and 30-day unplanned readmission after pediatric upper extremity surgery.
Methods:
Retrospective analysis of the 2013 National Surgery Quality Improvement Program pediatric database to identify procedures that met the CPT code of a primary upper extremity procedure. A univariate and multivariate analysis was performed to identify patient- and surgery-related risk factors for complications, reoperations and 30-day unplanned readmissions.
Results:
Upper extremity pediatric surgeries have low complication (1.70%), reoperation (0.5%) and readmission rates (0.78%). Procedures requiring reoperation, inpatient procedures, and those complicated by surgical site infection were more likely to be readmitted. Patients with complex medical histories such as cardiac disease, gastrointestinal disease, pulmonary disease, or a central nervous system disorder were more likely to be readmitted.
Conclusions:
Pediatric upper extremity surgery is safe and associated with low complication and readmission rates. Algorithms focusing on decreasing surgical site infection and optimizing complex pediatric medical problems may limit or further decrease complication and readmission rates.
Type Of Study/Level Of Evidence:
Prognostic III.
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