TY - JOUR
T1 - Influence of surgical volume on the mortality and morbidity of gastrointestinal perforation in children
AU - Terui, Keita
AU - Tachimori, Hisateru
AU - Oita, Satoru
AU - Fujiogi, Michimasa
AU - Fujishiro, Jun
AU - Hirahara, Norimichi
AU - Miyata, Hiroaki
AU - Hishiki, Tomoro
N1 - Publisher Copyright:
© The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. 2023.
PY - 2024/5
Y1 - 2024/5
N2 - Purpose: To clarify the influence of surgical volume on the mortality and morbidity of gastrointestinal perforation in children in Japan. Methods: We collected data on pediatric patients with gastrointestinal perforation between 2017 and 2019, from the National Clinical Database. The surgical volumes of various institutions were classified into three groups: low (average number of surgeries for gastrointestinal perforation/year < 1), medium (≥ 1, < 6), and high (≥ 6). The observed-to-expected (o/e) ratios of 30-day mortality and morbidity were calculated for each group using an existing risk model. Results: Among 1641 patients (median age, 0.0 years), the 30-day mortality and morbidity rates were 5.2% and 37.7%, respectively. The 30-day mortality rates in the low-, medium-, and high-volume institutions were 4.9%, 5.3%, and 5.1% (p = 0.94), and the 30-day morbidity rates in the three groups were 26.8%, 39.7%, and 37.7% (p < 0.01), respectively. The o/e ratios of 30-day mortality were 1.05 (95% confidence interval [CI] 0.83–1.26), 1.08 (95% CI 1.01–1.15), and 1.02 (95% CI 0.91–1.13), and those of 30-day morbidity were 1.72 (95% CI 0.93–2.51), 1.03 (95% CI 0.79–1.28), and 0.95 (95% CI 0.56–1.33), respectively. Conclusion: Surgical volume does not have significant impact on the outcomes of pediatric gastrointestinal perforation in Japan.
AB - Purpose: To clarify the influence of surgical volume on the mortality and morbidity of gastrointestinal perforation in children in Japan. Methods: We collected data on pediatric patients with gastrointestinal perforation between 2017 and 2019, from the National Clinical Database. The surgical volumes of various institutions were classified into three groups: low (average number of surgeries for gastrointestinal perforation/year < 1), medium (≥ 1, < 6), and high (≥ 6). The observed-to-expected (o/e) ratios of 30-day mortality and morbidity were calculated for each group using an existing risk model. Results: Among 1641 patients (median age, 0.0 years), the 30-day mortality and morbidity rates were 5.2% and 37.7%, respectively. The 30-day mortality rates in the low-, medium-, and high-volume institutions were 4.9%, 5.3%, and 5.1% (p = 0.94), and the 30-day morbidity rates in the three groups were 26.8%, 39.7%, and 37.7% (p < 0.01), respectively. The o/e ratios of 30-day mortality were 1.05 (95% confidence interval [CI] 0.83–1.26), 1.08 (95% CI 1.01–1.15), and 1.02 (95% CI 0.91–1.13), and those of 30-day morbidity were 1.72 (95% CI 0.93–2.51), 1.03 (95% CI 0.79–1.28), and 0.95 (95% CI 0.56–1.33), respectively. Conclusion: Surgical volume does not have significant impact on the outcomes of pediatric gastrointestinal perforation in Japan.
KW - Acute abdomen
KW - High-volume hospitals
KW - Intestinal perforation
KW - Morbidity
KW - Mortality
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U2 - 10.1007/s00595-023-02742-5
DO - 10.1007/s00595-023-02742-5
M3 - Article
C2 - 37615756
AN - SCOPUS:85168706478
SN - 0941-1291
VL - 54
SP - 419
EP - 427
JO - Surgery today
JF - Surgery today
IS - 5
ER -