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New initiative could help improve surgical outcomes in children, study suggests
Date:8/5/2013

peration would be comparing apples to oranges, Dr. Moss said. A key component of NSQIP is its ability to accurately adjust outcomes for patient risk factors. This means NSQIP is able to compare hospital performance even when the institutions see different patient populations.

When the ACS implemented its model for measuring surgical outcomes in adult surgery in 2004, it quickly became clear that, while that system would be useful in an adult setting, it couldn't be used by pediatric surgeons. Not only does the adult model include surgeries that aren't performed in children, but the range of post-surgical complications is also different, Dr. Moss, said. Adults often suffer complications as a result of diabetes, smoking-related respiratory problems or coronary disease comorbidities a surgeon wouldn't often see in a pediatric patient. Pediatric patients are more affected by congenital abnormalities and comorbidities specifically related to the diagnosis for which they are having surgery.

Procedures, comorbidities and potential complications are more specific to the pediatric population in the new model. In addition, this new program focuses more on morbidity as a measure of surgical outcomes, rather than mortality, which Dr. Moss said better encompasses the specific nature of pediatric surgery.

Furthermore, creating a "risk-adjusted" model allows pediatric surgeons to avoid the apples to oranges comparison, Dr. Moss said. Such elements as surgical case load, complexity of cases, patient demographics and other categories are factored into a highly precise algorithm. The resulting model allows a children's surgical department in a small-town hospital to meaningfully compare its outcomes with a large institution such as Nationwide Children's.

"In the unique world of children's surgery, we can now accurately obtain and share risk-adjusted outcomes in a way that will allow institutions to take actions that are going to improve patient ca
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Contact: Mary Ellen Peacock
maryellen.peacock@nationwidechildrens.org
614-355-0495
Nationwide Children's Hospital
Source:Eurekalert

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