Pediatric American College of Surgeons National Surgical Quality Improvement Program: Feasibility of a novel, prospective assessment of surgical outcomes

Mehul V. Raval, Peter W. Dillon, Jennifer L. Bruny, Clifford Y. Ko, Bruce L. Hall, R. Lawrence Moss, Keith T. Oldham, Karen E. Richards, Charles D. Vinocur, Moritz M. Ziegler

Research output: Contribution to journalArticle

112 Scopus citations

Abstract

Purpose: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides validated assessment of surgical outcomes. This study reports initiation of an ACS NSQIP Pediatric at 4 children's hospitals. Methods: From October 2008 to June 2009, 121 data variables were prospectively collected for 3315 patients, including 30-day outcomes and tailoring the ACS NSQIP methodology to children's surgical specialties. Results: Three hundred seven postoperative complications/occurrences were detected in 231 patients representing 7.0% of the study population. Of the patients with complications, 175 (75.7%) had 1, 39 (16.9%) had 2, and 17 (7.4%) had 3 or more complications. There were 13 deaths (0.39%) and 14 intraoperative occurrences (0.42%) detected. The most common complications were infection, 105 (34%) (SSI, 54; sepsis, 31; pneumonia, 13; urinary tract infection, 7); airway/respiratory events, 27 (9%); wound disruption, 18 (6%); neurologic events, 8 (3%) (nerve injury, 4; stroke/vascular event, 2; hemorrhage, 2); deep vein thrombosis, 3 (<1%); renal failure, 3 (<1%); and cardiac events, 3 (<1%). Current sampling captures 17.5% of cases across institutions with unadjusted complication rates ranging from 6.8% to 10.2%. Completeness of data collection for all variables exceeded 95% with 98% interrater reliability and 87% of patients having full 30-day follow-up. Conclusion: These data represent the first multiinstitutional prospective assessment of specialty-specific surgical outcomes in children. The ACS NSQIP Pediatric is poised for institutional expansion and future development of risk-adjusted models.

Original languageEnglish (US)
Pages (from-to)115-121
Number of pages7
JournalJournal of pediatric surgery
Volume46
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • ACS NSQIP
  • Outcomes
  • Pediatric surgery
  • Quality assessment

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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