American College of Surgeons National Surgical Quality Improvement Program Pediatric: a beta phase report.

The American College of Surgeons (ACS) National Surgical Quality Improvement Program Pediatric (NSQIP-P) expanded to beta phase testing with the enrollment of 29 institutions. Data collection and analysis were aimed at program refinement and development of risk-adjusted models for inter-institutional comparisons. Data from the first full year of beta-phase NSQIP-P were analyzed. Patient accrual used ACS-NSQIP methodology tailored to pediatric specialties. Preliminary risk adjusted modeling for all pediatric and neonatal operations and pediatric (excluding neonatal) abdominal operations was performed for all cause morbidity (other than death) and surgical site infections (SSI) using hierarchical logistic regression methodology and eight predictor variables. Results were expressed as odds ratios with 95% confidence intervals. During calendar year 2010, 29 institutions enrolled 37,141 patients. 1644 total CPT codes were entered, of which 456 accounted for 90% of the cases. 450 codes were entered only once (1.2% of cases). For all cases, overall mortality was 0.25%, overall morbidity 7.9%, and the SSI rate 1.8%. For neonatal cases, mortality was 2.39%, morbidity 18.7%, and the SSI rate 3%. For the all operations model, risk-adjusted morbidity institutional odds ratios ranged 0.48-2.63, with 9/29 hospitals categorized as low outliers and 9/29 high outliers, while risk-adjusted SSI institutional odds ratios ranged 0.36-2.04, with 2/29 hospitals low outliers and 7/29 high outliers. This report represents the first risk-adjusted hospital-level comparison of surgical outcomes in infants and children using NSQIP-P data. Programmatic and analytic modifications will improve the impact of this program as it moves into full implementation. These results indicate that NSQIP-P has the potential to serve as a model for determining risk-adjusted outcomes in the neonatal and pediatric population with the goal of developing quality improvement initiatives for the surgical care of children.

Bruny JL ，Hall BL ，Barnhart DC ，Billmire DF ，Dias MS ，Dillon PW ，Fisher C ，Heiss KF ，Hennrikus WL ，Ko CY ，Moss L ，Oldham KT ，Richards KE ，Shah R ，Vinocur CD ，Ziegler MM ... -  《-》

Risk adjustment in the American College of Surgeons National Surgical Quality Improvement Program: a comparison of logistic versus hierarchical modeling.

Cohen ME ，Dimick JB ，Bilimoria KY ，Ko CY ，Richards K ，Hall BL ... -  《-》

Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics.

Kuo BJ ，Vissoci JR ，Egger JR ，Smith ER ，Grant GA ，Haglund MM ，Rice HE ... -  《-》

Developing a NSQIP module to measure outcomes in children's surgical care: opportunity and challenge.

Dillon P ，Hammermeister K ，Morrato E ，Kempe A ，Oldham K ，Moss L ，Marchildon M ，Ziegler M ，Steeger J ，Rowell K ，Shiloach M ，Henderson W ... -  《Seminars in Pediatric Surgery》

Risk-adjusted hospital outcomes for children's surgery.

Saito JM ，Chen LE ，Hall BL ，Kraemer K ，Barnhart DC ，Byrd C ，Cohen ME ，Fei C ，Heiss KF ，Huffman K ，Ko CY ，Latus M ，Meara JG ，Oldham KT ，Raval MV ，Richards KE ，Shah RK ，Sutton LC ，Vinocur CD ，Moss RL ... -  《-》