Department of Pediatric and Adolescent Medicine, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
Department of Medicine, University of Calgary, Calgary, AB, Canada.
BMC Pediatr. 2022 Jun 22;22(1):358. doi: 10.1186/s12887-022-03418-8.
Several socio-demographic characteristics are associated with complications following certain pediatric surgical procedures. In this comprehensive study, we sought to determine socio-demographic risk factors and resource utilization of children with complications after common pediatric surgical procedures.
We performed a population-based cohort study utilizing the 2016 Healthcare Cost and Use Project Kids' Inpatient Database (KID) to identify and characterize pediatric patients (age 0-21 years) in the United States with common inpatient pediatric gastrointestinal surgical procedures: appendectomy, cholecystectomy, colonic resection, pyloromyotomy and small bowel resection. Multivariable logistic regression modeling was used to identify socio-demographic predictors of postoperative complications. Length of stay and hospitalization costs for patients with and without postoperative complications were compared.
A total of 66,157 pediatric surgical hospitalizations were identified. Of these patients, 2,009 had postoperative complications. Male sex, young age, African American and Native American race and treatment in a rural hospital were associated with significantly greater odds of postoperative complications. Mean length of stay was 4.58 days greater and mean total costs were $11,151 (US dollars) higher in the complication cohort compared with patients without complications.
Postoperative complications following inpatient pediatric gastrointestinal surgery were linked to elevated healthcare-related expenditure. The identified socio-demographic risk factors should be considered in the risk stratification before pediatric surgical procedures. Targeted interventions are required to reduce preventable complications and surgical disparities.
一些社会人口统计学特征与某些儿科手术的并发症有关。在这项全面的研究中，我们试图确定有并发症的儿童的社会人口统计学危险因素和资源利用情况，这些儿童患有常见的儿科外科手术。
我们进行了一项基于人群的队列研究，利用 2016 年医疗保健成本和使用项目儿童住院数据库（KID）来识别和描述美国患有常见住院儿科胃肠外科手术的儿童患者（0-21 岁）：阑尾切除术、胆囊切除术、结肠切除术、幽门肌切开术和小肠切除术。使用多变量逻辑回归模型来确定术后并发症的社会人口统计学预测因素。比较有和没有术后并发症的患者的住院时间和住院费用。
共确定了 66157 例儿科手术住院患者。其中，2009 例患者术后出现并发症。男性、年龄较小、非裔美国人和美洲原住民种族以及在农村医院治疗与术后并发症的发生几率显著增加有关。与无并发症的患者相比，并发症组的平均住院时间延长了 4.58 天，总费用增加了 11151 美元（美元）。
住院儿科胃肠外科手术后的并发症与医疗保健相关支出的增加有关。在进行儿科外科手术之前，应考虑到确定的社会人口统计学危险因素进行风险分层。需要采取有针对性的干预措施，以减少可预防的并发症和手术差异。
