دورية أكاديمية
Readmission characteristics of elective pediatric circumcisions using large-scale administrative data.
| العنوان: | Readmission characteristics of elective pediatric circumcisions using large-scale administrative data. |
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| المؤلفون: | Roth JD; Department of Urology, Section of Pediatric Urology, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4230, Indianapolis, IN 46202, USA. Electronic address: joshuarothmd@gmail.com., Keenan AC; Department of Urology, Section of Pediatric Urology, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4230, Indianapolis, IN 46202, USA., Carroll AE; Department of Pediatrics, Section of Pediatric and Adolescent Comparative Effectiveness Research, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4210, Indianapolis, IN 46202, USA., Rink RC; Department of Urology, Section of Pediatric Urology, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4230, Indianapolis, IN 46202, USA., Cain MP; Department of Urology, Section of Pediatric Urology, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4230, Indianapolis, IN 46202, USA., Whittam BM; Department of Urology, Section of Pediatric Urology, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4230, Indianapolis, IN 46202, USA., Bennett WE Jr; Department of Pediatrics, Section of Pediatric and Adolescent Comparative Effectiveness Research, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4210, Indianapolis, IN 46202, USA. |
| المصدر: | Journal of pediatric urology [J Pediatr Urol] 2016 Feb; Vol. 12 (1), pp. 27.e1-6. Date of Electronic Publication: 2015 Nov 14. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 101233150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4898 (Electronic) Linking ISSN: 14775131 NLM ISO Abbreviation: J Pediatr Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Kidlington, Oxford, UK : Elsevier, c2005- |
| مواضيع طبية MeSH: | Elective Surgical Procedures*, Circumcision, Male/*methods , Hospitals, Pediatric/*statistics & numerical data , Patient Readmission/*trends , Tertiary Care Centers/*statistics & numerical data, Adolescent ; Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Infant ; Male ; Reoperation ; Retrospective Studies ; Risk Factors ; United States |
| مستخلص: | Introduction and Background: Elective circumcision is a common procedure, known to be safe and associated with minimal morbidity. There are few data reporting the rates of readmission and reoperation following elective circumcision. Objective: We sought to define the rates of readmission and reoperation in the first 7 days following circumcision to accurately counsel families about the risks of this elective procedure. Study Design: The Pediatric Health Information System (PHIS) was interrogated from 2004 to 2013 for all ambulatory, elective circumcisions (ICD-9 CM code of 640). We assessed readmission with respect to age, insurance status, race, readmission diagnosis, time to readmission, and seasonal differences (due to higher rates of all-cause hospital admissions). We performed logistical regression analysis with a dependent variable of readmission within 7 days and independent variables of age, race, month of admission, and insurance status. Results: We identified 95,046 circumcisions from 2004 to 2013 performed in ambulatory surgery centers. Of those, 2906 (3.1%) of patients had an additional encounter at the same facility within 7 days. A total of 2409 (2.4%) of encounters were ER visits, and 253 (0.3%) were encounters for hospital admission or observation. One hundred and thirty-two patients (0.1%) underwent a second ambulatory procedure within the first 7 days following circumcision. Black patients (OR 1.26, p < 0.001) and patients on Medicaid (OR 1.63, p < 0.001) were more likely to seek care of any kind at the same institution within 7 days of the original circumcision operation. No difference was found with regard to time of year on logistic regression. Older age at circumcision was associated with increased likelihood of reoperation compared to children <1 year, with children 12-18 years old having an OR of 1.91 (p = 0.033). Discussion: We present a descriptive study of clinical events occurring at the same tertiary children's hospital within the first 7 days following more than 95,000 elective postneonatal circumcisions. Limitations include a cohort generated from a single set of ICD-9 codes, and a follow-up of 7 days. Conclusion: Elective circumcision remains a safe procedure with a readmission rate of 0.3%, and a reoperative rate of 0.1%. However, a relatively high percentage of patients (3.1%) will have a secondary encounter within the first 7 days following circumcision, most of them seeking care in an ER, although not necessarily for circumcision-related reasons. These may be useful data when counseling patients. (Published by Elsevier Ltd.) |
| فهرسة مساهمة: | Keywords: Complications; Post-neonatal circumcision; Readmission; Reoperation |
| تواريخ الأحداث: | Date Created: 20151209 Date Completed: 20161220 Latest Revision: 20161230 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jpurol.2015.10.006 |
| PMID: | 26643790 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1873-4898 |
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| DOI: | 10.1016/j.jpurol.2015.10.006 |