Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents

Mizrahi, Ido; Mazeh, Haggi; Levy, Yair; Karavani, Gilad; Ghanem, Muhammad; Armon, Yaron; Vromen, Amos; Eid, Ahmed; Udassin, Raphael

doi:10.1016/j.jss.2012.04.021

Cited by 31 publications

(61 citation statements)

References 27 publications

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“…The present study showed that the rate of appendiceal perforation among patients treated by PS was higher than that in patients treated by GS (48% vs 25%). These findings are in line with other studies that have shown higher rates of complicated appendicitis (ranging from 32% to 54%) in children operated on by PS …”

Section: Discussionsupporting

confidence: 93%

“…Inaccurate or delayed diagnosis may lead to unnecessary surgery and potentially avoidable morbidity. The expectation that children with suspected appendicitis would be better managed by a specialist and, consequently, would have better outcome, has not been confirmed in some studies …”

Section: Discussionmentioning

confidence: 99%

“…Despite the frequency of acute appendicitis and its financial costs, few studies have compared outcome in appendectomy performed by PS and GS . These studies have provided contradictory results.…”

mentioning

confidence: 99%

“…These studies have provided contradictory results. While some authors have found shorter length of hospital stay (LOS), lower complication rates, lower negative appendectomy rate, less antibiotic use, and lower hospital cost to be associated with PS, other studies have noted better outcome for appendectomies managed by GS or no differences in clinical outcome …”

mentioning

confidence: 99%

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Pediatric surgeon vs general surgeon: Does subspecialty training affect the outcome of appendicitis?

Silva

Aguiar

Waisberg

2014

Pediatrics International

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Pediatric surgeon vs general surgeon: Does subspecialty training affect the outcome of appendicitis?

Silva

Aguiar

Waisberg

2014

Pediatrics International

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“…Although studies based on hospital charges have generally found that teaching hospitals are more expensive, [1][2][3][4][5] studies that attempted to compare actual use have often yielded conflicting results. Although studies based on hospital charges have generally found that teaching hospitals are more expensive, [1][2][3][4][5] studies that attempted to compare actual use have often yielded conflicting results.…”

Section: Discussionmentioning

confidence: 99%

Where are Length of Stays Longer and Total Charges Higher for Pediatric Burn Patients?

Myers

Lehna

2014

Journal of Burn Care & Research

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Treatment of pediatric burn patients is costly and may require long length of stay in the hospital (LOS). Establishing where these LOS and charges are highest is warranted. The current study investigated whether pediatric burn patients had higher total charges and longer LOS when seen at teaching hospitals, when compared with nonteaching hospitals. The study reviewed inpatient admissions for pediatric burn patients in 2003, 2006, and 2009 by using the Kids' Inpatient Database, which is part of the Healthcare Cost and Utilization Project. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 940-947 were used to define burn injury, LOS, total charges, and type of hospital. The authors tested for differences between the LOS and total charges between children seen at three types of hospitals (pediatric, nonpediatric/teaching, nonpediatric/nonteaching) while adjusting for traditional risk factors (eg age, total burn surface area) by using generalized linear mixed-effects modeling. A total of N=28,777 children had burn injuries (n=16,115, 56.0% seen at pediatric hospitals; n=9353, 32.5% seen at nonpediatric/teaching hospitals; and n=3309, 11.5% seen at nonpediatric/nonteaching hospitals). Pediatric burn patients seen at pediatric hospitals, unadjusted, have significantly longer LOS (5.54 days vs 4.25 days and 4.00 days, P<.001) and more total charges in 2009 dollars ($31,319 vs $24,413 and $21,499, P<.001). In addition, patients seen at pediatric hospitals had significantly more total burn surface area (P<.001), more comorbidities (P=.021), and were younger (P<.001). After adjusting for total burn surface area, number of comorbidities, and age, no differences existed between teaching and nonteaching hospitals for LOS (P=.481) or total charges (P=.758). Although pediatric burn patients may have increased LOS and total charges when seen at teaching hospitals, when taking an unadjusted perspective, this may be an artifact that teaching hospitals see pediatric burn patients who are younger, have more comorbidities, and have more total burn surface area. As such, after adjustment, type of hospital may have no influence on LOS and total charges.

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Comparison of Appendectomy Outcomes Between Senior General Surgeons and General Surgery Residents

et al. 2017

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Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents

Cited by 31 publications

References 27 publications

Pediatric surgeon vs general surgeon: Does subspecialty training affect the outcome of appendicitis?

Pediatric surgeon vs general surgeon: Does subspecialty training affect the outcome of appendicitis?

Where are Length of Stays Longer and Total Charges Higher for Pediatric Burn Patients?

Comparison of Appendectomy Outcomes Between Senior General Surgeons and General Surgery Residents

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