Document Detail

Hospital type predicts surgical complications for infants with hypertrophic pyloric stenosis.
MedLine Citation:
PMID:  23025945     Owner:  NLM     Status:  In-Data-Review    
Pyloromyotomy is a common surgery performed for hypertrophic pyloric stenosis at community and children's hospitals. To determine hospital-level factors that may affect clinical outcomes, infants requiring pyloromyotomy from 1999 to 2007 (n = 8379) were retrospectively reviewed from the California linked birth cohort data set. Hospital case volume and type (community, children's, adult hospital with children's unit) were examined. Surgical complications, prolonged length of stay (LOS), and 30-day readmission were analyzed with multivariate logistic regression. Overall, surgical complications occurred in 166 (2%) infants, 35 (21%) after discharge. Readmission occurred in 285 (3.4%) infants with 69 (24%) admitted to hospitals that did not perform the initial surgery. Infants treated at community hospitals (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.1 to 4.0) experienced an increased likelihood of surgical complications. Odds of surgical complications did not vary by hospital case volume. Prolonged LOS was increased at community hospitals (OR, 1.7; 95% CI, 1.2 to 2.3), low- (OR, 2.1; 95% CI, 1.3 to 3.4), and medium-volume (OR, 1.6; 95% CI, 1.0 to 2.7) hospitals. Hospital type and volume did not impact 30-day readmission. In conclusion, specialized surgical care for infants administered at pediatric centers appears to influence pyloromyotomy complications more than hospital case volume. Institutional components contributing to improved outcomes in specialty centers warrant further investigation.
Lorraine I Kelley-Quon; Chi-Hong Tseng; Howard C Jen; Stephen B Shew
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  78     ISSN:  1555-9823     ISO Abbreviation:  Am Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1079-82     Citation Subset:  IM    
Division of Pediatric Surgery, Department of Surgery, Mattel Children's Hospital, Los Angeles, California, USA.
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