دورية أكاديمية
أعرض في EDS

Postoperative complications and health care use in children undergoing surgery for ulcerative colitis.

التفاصيل البيبلوغرافية
العنوان: Postoperative complications and health care use in children undergoing surgery for ulcerative colitis.
المؤلفون: Kelley-Quon LI; Division of Pediatric Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7098, USA., Tseng CH, Jen HC, Ziring DA, Shew SB
المصدر: Journal of pediatric surgery [J Pediatr Surg] 2012 Nov; Vol. 47 (11), pp. 2063-70.
نوع المنشور: Evaluation Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : Saunders
Original Publication: New York.
مواضيع طبية MeSH: Proctocolectomy, Restorative*/methods, Colitis, Ulcerative/*surgery , Hospitalization/*statistics & numerical data , Postoperative Complications/*etiology, Adolescent ; California ; Child ; Child, Preschool ; Cohort Studies ; Female ; Hospitals, Pediatric/statistics & numerical data ; Humans ; Length of Stay/statistics & numerical data ; Linear Models ; Logistic Models ; Male ; Multivariate Analysis ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Retrospective Studies ; Treatment Outcome
مستخلص: Objectives: Medical and surgical approaches toward children with ulcerative colitis (UC) vary and have differing implications for health care use. The goal of this study was to define hospital use and complications for children with UC before and after staged restorative proctocolectomy.
Patients and Methods: A retrospective study of the California Patient Discharge Dataset from 1999 to 2007 of children aged 2 to 18 years with UC who underwent colectomy was performed (N = 218). Surgical staging was determined alongside hospital type (children's vs non-children's) and surgical case volume. Postoperative complications and hospital length of stay were analyzed using multivariate regression.
Results: The cohort was mostly male (56%) and white (80%), had private insurance (78%), and underwent colectomy at a children's hospital (62%). Overall, 65% required a separate hospital admission before admission for colectomy. Single-, 2-, and 3-stage procedures were performed in 19 (9%), 144 (66%), and 38 (17%) children. The mean admissions per patient were 1.8 ± 2.4 before colectomy and 0.7 ± 1.6 after surgical completion. Surgical complications occurred in 100 (49%) children, with 39% being attributed to postoperative infection. Children with public insurance (odds ratio, 2.18; 95% confidence interval, 1.0-4.85) and those who underwent colectomy at a non-children's hospital (odds ratio, 2.53; 95% confidence interval, 1.0-6.37) had increased likelihood of surgical complications. Finally, nonwhite race, surgical staging, and undergoing colectomy at a low- or medium-volume hospital resulted in prolonged hospitalization (P < .05).
Conclusions: Children with UC who undergo colectomy use a large number of hospital resources before surgery and exhibit decreased hospital use after surgical completion. Children undergoing colectomy at children's and high-volume hospitals experience fewer surgical complications and shorter hospitalization.
(Copyright © 2012. Published by Elsevier Inc.)
معلومات مُعتمدة: HD052885 United States HD NICHD NIH HHS
SCR Disease Name: Pediatric ulcerative colitis
تواريخ الأحداث: Date Created: 20121121 Date Completed: 20130503 Latest Revision: 20191210
رمز التحديث: 20231215
DOI: 10.1016/j.jpedsurg.2012.07.001
PMID: 23163999
قاعدة البيانات: MEDLINE
الوصف
تدمد:1531-5037
DOI:10.1016/j.jpedsurg.2012.07.001