PMID- 26299570
OWN - NLM
STAT- MEDLINE
DCOM- 20151215
LR  - 20220331
IS  - 1879-1190 (Electronic)
IS  - 1072-7515 (Linking)
VI  - 221
IP  - 4
DP  - 2015 Oct
TI  - Does the American College of Surgeons NSQIP-Pediatric Accurately Represent 
      Overall Patient Outcomes?
PG  - 828-36
LID - S1072-7515(15)00508-6 [pii]
LID - 10.1016/j.jamcollsurg.2015.07.014 [doi]
AB  - BACKGROUND: The National Surgical Quality Improvement Program-Pediatrics 
      (NSQIP-P) collects data for institutional quality benchmarking of surgery 
      performed on children using a sampling algorithm. The Pediatric and Infant Case 
      Log and Outcomes (PICaLO) is a database of all general and thoracic pediatric 
      surgery (GTPS) procedures performed at our institution with the attendant 
      complications. This study compared postsurgical occurrences in a NSQIP-P sample 
      with all postoperative occurrences at a single institution to test the hypothesis 
      that a sample of higher risk procedures represents the actual event rate for all 
      higher risk procedures. STUDY DESIGN: The definitions of postoperative 
      occurrences used in PICaLO are derived from NSQIP-P but tracked past 30 days 
      postoperatively and include additional occurrences (ie, anastomotic leak). The 
      number and types of occurrences and number of deaths from PICaLO and NSQIP-P 
      databases were compared for procedures specific to pediatric GTPS procedures 
      during 2012 to 2013. A chi-square test evaluated the proportion of occurrences 
      and deaths in PICaLO to NSQIP-P. RESULTS: The NSQIP-P sampled 37.7% of eligible 
      GTS procedures recorded in PICaLO during the study period. The proportion of 
      cases with 1 or more occurrences was significantly higher in the NSQIP-P dataset 
      when compared with all cases in PICaLO (p < 0.0001). When NSQIP-P and PICaLO were 
      compared based on specific CPT codes, NSQIP-P still had a higher event rate (p = 
      0.004). CONCLUSIONS: In focused comparisons, the data demonstrate that the 
      NSQIP-P sampling algorithm successfully identifies CPT codes with higher 
      postoperative event rates than the overall cohort of pediatric GTPS patients, but 
      may not be reflective of the total experience for procedures with those CPT 
      codes.
CI  - Copyright (c) 2015 American College of Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Gross, Erica R
AU  - Gross ER
AD  - Division of Pediatric Surgery, Children's Hospital of Wisconsin, Milwaukee, WI.
FAU - Christensen, Melissa
AU  - Christensen M
AD  - Division of Pediatric Surgery, Children's Hospital of Wisconsin, Milwaukee, WI.
FAU - Schultz, Jessica A
AU  - Schultz JA
AD  - Division of Analytics, Children's Hospital of Wisconsin, Milwaukee, WI.
FAU - Cassidy, Laura D
AU  - Cassidy LD
AD  - Division of Pediatric Surgery, Children's Hospital of Wisconsin, Milwaukee, WI.
FAU - Anderson, Yvonne
AU  - Anderson Y
AD  - Division of Pediatric Surgery, Children's Hospital of Wisconsin, Milwaukee, WI.
FAU - Arca, Marjorie J
AU  - Arca MJ
AD  - Division of Pediatric Surgery, Children's Hospital of Wisconsin, Milwaukee, WI. 
      Electronic address: marca@mcw.edu.
LA  - eng
PT  - Journal Article
DEP - 20150720
PL  - United States
TA  - J Am Coll Surg
JT  - Journal of the American College of Surgeons
JID - 9431305
SB  - IM
MH  - Child
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Outcome Assessment, Health Care/*methods
MH  - Pediatrics/*standards
MH  - Postoperative Complications/epidemiology
MH  - *Quality Improvement
MH  - Retrospective Studies
MH  - Specialties, Surgical/*standards
MH  - Thoracic Surgical Procedures/*standards
MH  - Wisconsin/epidemiology
EDAT- 2015/08/25 06:00
MHDA- 2015/12/17 06:00
CRDT- 2015/08/25 06:00
PHST- 2015/04/20 00:00 [received]
PHST- 2015/07/10 00:00 [revised]
PHST- 2015/07/13 00:00 [accepted]
PHST- 2015/08/25 06:00 [entrez]
PHST- 2015/08/25 06:00 [pubmed]
PHST- 2015/12/17 06:00 [medline]
AID - S1072-7515(15)00508-6 [pii]
AID - 10.1016/j.jamcollsurg.2015.07.014 [doi]
PST - ppublish
SO  - J Am Coll Surg. 2015 Oct;221(4):828-36. doi: 10.1016/j.jamcollsurg.2015.07.014. 
      Epub 2015 Jul 20.