کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4155265 1273741 2015 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Influence of hospital and patient location on early postoperative outcomes after appendectomy and pyloromyotomy
ترجمه فارسی عنوان
تأثیر موقعیت بیمارستانی و بیمار در نتایج اولیه پس از عمل آپاندکتومی و پیلورومیوتومی
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
چکیده انگلیسی

BackgroundThe effects of hospital location and designation on postoperative pediatric outcomes remain unclear. We hypothesized that urban hospital outcomes would be superior to rural hospitals, and that outcomes at urban centers would differ for children from rural versus urban counties.MethodsRetrospective cohort study of children undergoing appendectomy (n = 129,507) and pyloromyotomy (n = 13,452) using the 2006/2009 KID databases. Hospitals were characterized by specialty designation and classified as urban/rural. County of residence was classified as urban/rural. Outcomes included complications and length of stay. Multivariate regression models were used to adjust for confounding.ResultsAmong appendectomy patients, treatment at urban hospitals was associated with reduced odds of any postoperative complication (OR = 0.77, 95% C.I. 0.70–0.85) and anesthesia-related complications (OR = 0.72, 95% C.I. 0.57–0.91). This association was strongest in the youngest children (< 5 years) and at children’s hospitals. For pyloromyotomy patients, urban hospitals were associated with reduced odds of any complication (OR = 0.43, 95% C.I. 0.24–0.75), anesthesia-related complications (OR = 0.14, 95% C.I. 0.05–0.37), and duodenal perforation (OR = 0.46, 95% C.I. 0.19–1.07). These associations were most significant at children’s hospitals.ConclusionsPostoperative outcomes appear to be improved at urban specialty hospitals relative to rural hospitals for certain common pediatric procedures. Identification of the factors driving this association may help inform resource optimization efforts in pediatric surgery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Pediatric Surgery - Volume 50, Issue 9, September 2015, Pages 1549–1555
نویسندگان
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