Influence of surgical volume on the mortality and morbidity of gastrointestinal perforation in children
Document Type
Article
Publication Date
5-1-2024
Abstract
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.
Keywords
Intestinal perforation, Acute abdomen, High-volume hospitals, Morbidity, Mortality
Divisions
fac_med
Funders
Health Care Science Institute
Publication Title
Surgery Today
Volume
54
Issue
5
Publisher
Springer
Publisher Location
ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES