Hospital Volume Impacts Post-Op Urologic Complications in Children

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Risk of postoperative complications increased for pediatric patients at non-high volume hospitals.
Risk of postoperative complications increased for pediatric patients at non-high volume hospitals.

(HealthDay News) -- For pediatric patients hospitalized for urological procedures, the risk of postoperative complications is increased at non-high volume hospitals, according to research published in The Journal of Urology.

Hsin-Hsiao S. Wang, M.D., M.P.H., from the Duke University Medical Center in Durham, N.C., and colleagues conducted a retrospective review of the Nationwide Inpatient Sample (1998 to 2011) for pediatric hospitalizations for urological procedures. The authors examined the correlation for hospital and provider surgical volume with surgical outcome in 158,805 urological admissions (114,634 at high volume and 44,171 at non-high volume hospitals).

The researchers found that 75% of the hospitals recorded fewer than 5 major pediatric urology cases performed yearly. Significantly younger patients were treated at high volume hospitals (mean 5.4 versus 9.6 years; P < 0.001); high volume hospitals were more likely to be teaching hospitals (93 versus 71%; P < 0.001). 

At non-high versus high volume hospitals, the overall rate of National Surgical Quality Improvement Program (NSQIP)-identified postoperative complications was higher (11.6 versus 9.3%; P = 0.003). Patients treated at non-high volume hospitals were more likely to suffer multiple NSQIP-tracked postoperative complications, after adjustment for confounding variables.

"Urological procedures performed in children at non-high volume hospitals were associated with an increased risk of in-hospital, NSQIP-identified postoperative complications, including a small but significant increase in postoperative mortality, mostly following nephrectomy and percutaneous nephrolithotomy," the authors write.

Sources

  1. Hsin-Hsiao S. Wang, Rohit Tejwani, Haijing Zhang, et al; The Journal of Urology, August 2015; doi: 10.1016/j.juro.2015.01.096
  2. Eric A. Kurzrock. The Journal of Urology, August 2015; doi: 10.1016/j.juro.2015.01.128.
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