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National Databases in Pediatric Orthopaedic Surgery: A Comparison of Demographics, Procedures, and Outcomes

Ilya M Gutman1, Thomas E Niemeier, Shawn R Gilbert

  • 1Children's of Alabama, Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.

Journal of Pediatric Orthopedics
|August 9, 2019
PubMed

Insights

Pediatric orthopaedic surgery outcomes differ significantly between the Kids' Inpatient Database (KID) and the National Surgical Quality Improvement Program Pediatric (NSQIP Pediatric) database. Researchers must understand these database disparities for accurate patient representation.

Area of Science:

  • Orthopaedic Surgery
  • Health Services Research
  • Pediatric Healthcare

Background:

  • Large national databases are crucial for analyzing adverse events and surgical outcomes in pediatric populations.
  • Evaluating rare events like 30-day mortality is a key application of these databases.
  • No prior studies have compared pediatric orthopaedic data across different national databases.

Purpose of the Study:

  • To compare the Kids' Inpatient Database (KID) and the American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP Pediatric) databases.
  • To identify differences in patient characteristics and complication rates for common pediatric orthopaedic procedures.

Main Methods:

  • The KID and NSQIP Pediatric databases were queried for pediatric orthopaedic procedures including humeral fractures, scoliosis, slipped capital femoral epiphysis, and femoral fractures.
  • Patient demographics, clinical characteristics, and complications were compared using statistical tests (Student t test, χ², Fisher's exact test).
  • Study design: Level III, prognostic study.

Main Results:

  • A total of 26,978 patients from KID and 5,186 from NSQIP Pediatric were analyzed.
  • Significant differences were found in age, race, sex, and length of stay between the two databases for identical procedures.
  • NSQIP Pediatric reported statistically higher cumulative complication rates, with surgical site infections and sepsis at least twice as common compared to KID.

Conclusions:

  • The KID and NSQIP Pediatric databases exhibit clinically and statistically significant differences.
  • Researchers and clinicians must be aware of variations in data import, quality control, and sampling when using these large databases.
  • Understanding these differences is essential for accurate population representation and reliable research findings.
Abstract

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