دورية أكاديمية
Surgical Urgency, Patient Comorbidities, and Socioeconomic Factors in Surgical Site Infections in Pediatric Surgery.
| العنوان: | Surgical Urgency, Patient Comorbidities, and Socioeconomic Factors in Surgical Site Infections in Pediatric Surgery. |
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| المؤلفون: | Quintero LA; General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA., Hernandez J; General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA., Orduno Villa N; General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA., Romero D; General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA., Spector C; General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA., Ngo L; General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA., Shatawi Z; General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA., Levene T; Department of Pediatric Surgery, Joe DiMaggio Children's Hospital, Hollywood, FL, USA., Lao O; Department of Pediatric Surgery, Joe DiMaggio Children's Hospital, Hollywood, FL, USA., Parreco JP; Trauma Critical Care Surgery, Florida Atlantic University, Hollywood, FL, USA. |
| المصدر: | The American surgeon [Am Surg] 2024 Sep; Vol. 90 (9), pp. 2249-2252. Date of Electronic Publication: 2024 Jun 13. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: SAGE Publications in association with Southeastern Surgical Congress Country of Publication: United States NLM ID: 0370522 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-9823 (Electronic) Linking ISSN: 00031348 NLM ISO Abbreviation: Am Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2020- : [Thousand Oaks, CA] : SAGE Publications in association with Southeastern Surgical Congress Original Publication: Atlanta Ga : Southeastern Surgical Congress |
| مواضيع طبية MeSH: | Surgical Wound Infection*/epidemiology , Digestive System Surgical Procedures*/adverse effects , Patient Readmission*/statistics & numerical data , Comorbidity* , Socioeconomic Factors*, Humans ; Child ; Adolescent ; Male ; Female ; Child, Preschool ; Risk Factors ; United States/epidemiology ; Infant ; Retrospective Studies |
| مستخلص: | Background: The rise of value-based purchasing has led to decreased compensation for hospital-acquired conditions, including surgical site infections (SSI). This study aims to assess the risk factors for SSI in children and teenagers undergoing gastrointestinal surgery across US hospitals. Methods: The 2018-2020 Nationwide Readmissions Database was queried for patients undergoing gastrointestinal surgery under the age of 18. The primary outcome was SSI during index admission or readmission within a year. Comparison groups were elective, trauma, and emergent surgery based on anatomic location and urgency. Univariable comparison used chi-squared tests for relevant variables. Confounders were addressed through multivariable logistic regression with significant variables from univariable analysis. Results: 113 108 total patients met the study criteria. The SSI rate during admission or readmission was 2.9% (n = 3254). Infections during admission and readmission were 1.4% (n = 1560) and 1.5% (n = 1694), respectively. The most common site was organ space (48.6%, n = 1657). Increased infection risk was associated with trauma (OR 1.80 [1.51-2.16] P < .001), emergency surgery (OR 1.31 [1.17-1.47] P < .001), large bowel surgery (OR 2.78 [2.26-3.43] P < .001), and those with three or more comorbidities (OR 2.03 [1.69-2.45] P < .001). Investor-owned hospitals (OR .65 [.56-.76] P < .001) and highest quartile income (OR .80 [.73-.88] P < .001) were associated with decreased infection risk. Conclusions: Pediatric patients undergoing gastrointestinal surgery face an elevated risk of SSI, especially in trauma and emergency surgeries, particularly with multiple comorbidities. Meanwhile, a reduced risk is observed in high-income and investor-owned hospital settings. Hospitals and surgeons caring for high risk patients should advocate for risk adjustment in value-based payment systems. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| فهرسة مساهمة: | Keywords: pediatric surgery; socioeconomic factors; surgical site infections |
| تواريخ الأحداث: | Date Created: 20240613 Date Completed: 20240820 Latest Revision: 20240820 |
| رمز التحديث: | 20240820 |
| DOI: | 10.1177/00031348241260265 |
| PMID: | 38871348 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1555-9823 |
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| DOI: | 10.1177/00031348241260265 |