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Outcomes and Resource Utilization Associated with Use of Routine Pre-Discharge White Blood Cell Count for Clinical Decision-Making in Children with Complicated Appendicitis: A Multicenter Hospital-Level Analysis
The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis. Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered rout...
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| Published in: | Journal of pediatric surgery 2023-06, Vol.58 (6), p.1178-1184 |
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| cites | cdi_FETCH-LOGICAL-c315t-1d18aedb5fcfde54fb2107ac243591bedde44075ca53650b5e824c164c65b6e63 |
| container_end_page | 1184 |
| container_issue | 6 |
| container_start_page | 1178 |
| container_title | Journal of pediatric surgery |
| container_volume | 58 |
| creator | Cramm, Shannon L. Graham, Dionne A. Blakely, Martin L. Chandler, Nicole M. Cowles, Robert A. Kunisaki, Shaun M. Russell, Robert T. Allukian, Myron DeFazio, Jennifer R. Griggs, Cornelia L. Santore, Matthew T. Scholz, Stefan Aronowitz, Danielle I. Campbell, Brendan T. Collins, Devon T. Commander, Sarah J. Engwall-Gill, Abigail Esparaz, Joseph R. Feng, Christina Gerall, Claire Hanna, David N. Keane, Olivia A. Lamoshi, Abdulraouf Lipskar, Aaron M. Orlas Bolanos, Claudia P. Pace, Elizabeth Regan, Maia D. Tracy, Elisabeth T. Williams, Sacha Zhang, Lucy Rangel, Shawn J. |
| description | The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis.
Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered routine if obtained within one day of discharge in children who did not develop an organ space infection (OSI) or fever during the index admission. Hospital-level observed-to-expected ratios (O/E) for 30-day outcomes (antibiotic days, imaging utilization, healthcare days, and OSI) were calculated after adjusting for appendicitis severity and patient characteristics. Spearman correlation was used to explore the relationship between hospital-level RPD-WBC utilization and O/E's for each outcome.
1528 children were included. Significant variation was found across hospitals in RPD-WBC use (range: 0.7–100%; p |
| doi_str_mv | 10.1016/j.jpedsurg.2023.02.039 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2798713647</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022346823001604</els_id><sourcerecordid>2798713647</sourcerecordid><originalsourceid>FETCH-LOGICAL-c315t-1d18aedb5fcfde54fb2107ac243591bedde44075ca53650b5e824c164c65b6e63</originalsourceid><addsrcrecordid>eNqFkcFuEzEQhlcIREPhFSofuWyw1-vdhBNhCxQpVVFFxNHy2rPJBMfe2t6i8pq8EI7ScuU00uib-TXzFcUFo3NGWfNuP9-PYOIUtvOKVnxOqznly2fFjAnOSkF5-7yYUVpVJa-bxVnxKsY9pblN2cviLBdOl-1yVvy5mZL2B4hEOUNuIfopaCCbhBZ_q4TekVWMXqNKYMgvTDuyiUD8QG79lNAB-RagvMSodypsgfzYYQLy0XpvSAfWks5PLpHBB9JZdKiVJZegMebN5bX6iW5L0JFuh9YEcKeEzh9Gm9Fj5GocwRnUmDC-JytyPdmEGlyCQK58HDEpW67hHixZOWUfIsbXxYtB2QhvHut5sfn86Xt3Va5vvnztVutScyZSyQxbKDC9GPRgQNRDXzHaKl3VXCxZD8ZAXdNWaCV4I2gvYFHVmjW1bkTfQMPPi7envWPwdxPEJA_5D_lo5cBPUVbtctEy3tRtRpsTqoOPMcAgx4AHFR4ko_IoVO7lk1B5FCppJbPQPHjxmDH1BzD_xp4MZuDDCYB86T1CkFEjOA0GA-gkjcf_ZfwFebi6Pg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2798713647</pqid></control><display><type>article</type><title>Outcomes and Resource Utilization Associated with Use of Routine Pre-Discharge White Blood Cell Count for Clinical Decision-Making in Children with Complicated Appendicitis: A Multicenter Hospital-Level Analysis</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Cramm, Shannon L. ; Graham, Dionne A. ; Blakely, Martin L. ; Chandler, Nicole M. ; Cowles, Robert A. ; Kunisaki, Shaun M. ; Russell, Robert T. ; Allukian, Myron ; DeFazio, Jennifer R. ; Griggs, Cornelia L. ; Santore, Matthew T. ; Scholz, Stefan ; Aronowitz, Danielle I. ; Campbell, Brendan T. ; Collins, Devon T. ; Commander, Sarah J. ; Engwall-Gill, Abigail ; Esparaz, Joseph R. ; Feng, Christina ; Gerall, Claire ; Hanna, David N. ; Keane, Olivia A. ; Lamoshi, Abdulraouf ; Lipskar, Aaron M. ; Orlas Bolanos, Claudia P. ; Pace, Elizabeth ; Regan, Maia D. ; Tracy, Elisabeth T. ; Williams, Sacha ; Zhang, Lucy ; Rangel, Shawn J.</creator><creatorcontrib>Cramm, Shannon L. ; Graham, Dionne A. ; Blakely, Martin L. ; Chandler, Nicole M. ; Cowles, Robert A. ; Kunisaki, Shaun M. ; Russell, Robert T. ; Allukian, Myron ; DeFazio, Jennifer R. ; Griggs, Cornelia L. ; Santore, Matthew T. ; Scholz, Stefan ; Aronowitz, Danielle I. ; Campbell, Brendan T. ; Collins, Devon T. ; Commander, Sarah J. ; Engwall-Gill, Abigail ; Esparaz, Joseph R. ; Feng, Christina ; Gerall, Claire ; Hanna, David N. ; Keane, Olivia A. ; Lamoshi, Abdulraouf ; Lipskar, Aaron M. ; Orlas Bolanos, Claudia P. ; Pace, Elizabeth ; Regan, Maia D. ; Tracy, Elisabeth T. ; Williams, Sacha ; Zhang, Lucy ; Rangel, Shawn J. ; Eastern Pediatric Surgery Network ; Eastern Pediatric Surgery Network</creatorcontrib><description>The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis.
Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered routine if obtained within one day of discharge in children who did not develop an organ space infection (OSI) or fever during the index admission. Hospital-level observed-to-expected ratios (O/E) for 30-day outcomes (antibiotic days, imaging utilization, healthcare days, and OSI) were calculated after adjusting for appendicitis severity and patient characteristics. Spearman correlation was used to explore the relationship between hospital-level RPD-WBC utilization and O/E's for each outcome.
1528 children were included. Significant variation was found across hospitals in RPD-WBC use (range: 0.7–100%; p < 0.01) and all outcomes (mean antibiotic days: 9.9 [O/E range: 0.56–1.44, p < 0.01]; imaging: 21.9% [O/E range: 0.40–2.75, p < 0.01]; mean healthcare visit days: 5.7 [O/E 0.74–1.27, p < 0.01]); OSI: 14.1% [O/E range: 0.43–3.64, p < 0.01]). No correlation was found between RPD-WBC use and antibiotic days (r = +0.14, p = 0.64), imaging (r = −0.07, p = 0.82), healthcare days (r = +0.35, p = 0.23) or OSI (r = −0.13, p = 0.65).
Increased RPD-WBC utilization in pediatric complicated appendicitis did not correlate with improved outcomes or resource utilization at the hospital level.
III.
Clinical Research</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/j.jpedsurg.2023.02.039</identifier><identifier>PMID: 37030979</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Appendectomy - methods ; Appendicitis ; Appendicitis - complications ; Appendicitis - surgery ; Child ; Clinical Decision-Making ; Hospitals ; Humans ; Length of stay ; Leukocyte Count ; Organ space infection ; Patient Discharge ; Resource utilization ; Retrospective Studies ; White blood cell count</subject><ispartof>Journal of pediatric surgery, 2023-06, Vol.58 (6), p.1178-1184</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c315t-1d18aedb5fcfde54fb2107ac243591bedde44075ca53650b5e824c164c65b6e63</cites><orcidid>0000-0002-8531-4249 ; 0000-0003-0988-3260 ; 0000-0002-0985-9204 ; 0000-0002-3375-9158 ; 0000-0003-2116-1383 ; 0000-0002-8815-1262 ; 0000-0003-3459-2772 ; 0000-0002-7772-1637 ; 0000-0002-9229-4733 ; 0000-0002-2777-1839 ; 0000-0001-5784-1001 ; 0000-0003-2530-0328 ; 0000-0001-9923-0540 ; 0000-0003-0043-8558</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37030979$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cramm, Shannon L.</creatorcontrib><creatorcontrib>Graham, Dionne A.</creatorcontrib><creatorcontrib>Blakely, Martin L.</creatorcontrib><creatorcontrib>Chandler, Nicole M.</creatorcontrib><creatorcontrib>Cowles, Robert A.</creatorcontrib><creatorcontrib>Kunisaki, Shaun M.</creatorcontrib><creatorcontrib>Russell, Robert T.</creatorcontrib><creatorcontrib>Allukian, Myron</creatorcontrib><creatorcontrib>DeFazio, Jennifer R.</creatorcontrib><creatorcontrib>Griggs, Cornelia L.</creatorcontrib><creatorcontrib>Santore, Matthew T.</creatorcontrib><creatorcontrib>Scholz, Stefan</creatorcontrib><creatorcontrib>Aronowitz, Danielle I.</creatorcontrib><creatorcontrib>Campbell, Brendan T.</creatorcontrib><creatorcontrib>Collins, Devon T.</creatorcontrib><creatorcontrib>Commander, Sarah J.</creatorcontrib><creatorcontrib>Engwall-Gill, Abigail</creatorcontrib><creatorcontrib>Esparaz, Joseph R.</creatorcontrib><creatorcontrib>Feng, Christina</creatorcontrib><creatorcontrib>Gerall, Claire</creatorcontrib><creatorcontrib>Hanna, David N.</creatorcontrib><creatorcontrib>Keane, Olivia A.</creatorcontrib><creatorcontrib>Lamoshi, Abdulraouf</creatorcontrib><creatorcontrib>Lipskar, Aaron M.</creatorcontrib><creatorcontrib>Orlas Bolanos, Claudia P.</creatorcontrib><creatorcontrib>Pace, Elizabeth</creatorcontrib><creatorcontrib>Regan, Maia D.</creatorcontrib><creatorcontrib>Tracy, Elisabeth T.</creatorcontrib><creatorcontrib>Williams, Sacha</creatorcontrib><creatorcontrib>Zhang, Lucy</creatorcontrib><creatorcontrib>Rangel, Shawn J.</creatorcontrib><creatorcontrib>Eastern Pediatric Surgery Network</creatorcontrib><creatorcontrib>Eastern Pediatric Surgery Network</creatorcontrib><title>Outcomes and Resource Utilization Associated with Use of Routine Pre-Discharge White Blood Cell Count for Clinical Decision-Making in Children with Complicated Appendicitis: A Multicenter Hospital-Level Analysis</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis.
Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered routine if obtained within one day of discharge in children who did not develop an organ space infection (OSI) or fever during the index admission. Hospital-level observed-to-expected ratios (O/E) for 30-day outcomes (antibiotic days, imaging utilization, healthcare days, and OSI) were calculated after adjusting for appendicitis severity and patient characteristics. Spearman correlation was used to explore the relationship between hospital-level RPD-WBC utilization and O/E's for each outcome.
1528 children were included. Significant variation was found across hospitals in RPD-WBC use (range: 0.7–100%; p < 0.01) and all outcomes (mean antibiotic days: 9.9 [O/E range: 0.56–1.44, p < 0.01]; imaging: 21.9% [O/E range: 0.40–2.75, p < 0.01]; mean healthcare visit days: 5.7 [O/E 0.74–1.27, p < 0.01]); OSI: 14.1% [O/E range: 0.43–3.64, p < 0.01]). No correlation was found between RPD-WBC use and antibiotic days (r = +0.14, p = 0.64), imaging (r = −0.07, p = 0.82), healthcare days (r = +0.35, p = 0.23) or OSI (r = −0.13, p = 0.65).
Increased RPD-WBC utilization in pediatric complicated appendicitis did not correlate with improved outcomes or resource utilization at the hospital level.
III.
Clinical Research</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Appendectomy - methods</subject><subject>Appendicitis</subject><subject>Appendicitis - complications</subject><subject>Appendicitis - surgery</subject><subject>Child</subject><subject>Clinical Decision-Making</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Length of stay</subject><subject>Leukocyte Count</subject><subject>Organ space infection</subject><subject>Patient Discharge</subject><subject>Resource utilization</subject><subject>Retrospective Studies</subject><subject>White blood cell count</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqFkcFuEzEQhlcIREPhFSofuWyw1-vdhBNhCxQpVVFFxNHy2rPJBMfe2t6i8pq8EI7ScuU00uib-TXzFcUFo3NGWfNuP9-PYOIUtvOKVnxOqznly2fFjAnOSkF5-7yYUVpVJa-bxVnxKsY9pblN2cviLBdOl-1yVvy5mZL2B4hEOUNuIfopaCCbhBZ_q4TekVWMXqNKYMgvTDuyiUD8QG79lNAB-RagvMSodypsgfzYYQLy0XpvSAfWks5PLpHBB9JZdKiVJZegMebN5bX6iW5L0JFuh9YEcKeEzh9Gm9Fj5GocwRnUmDC-JytyPdmEGlyCQK58HDEpW67hHixZOWUfIsbXxYtB2QhvHut5sfn86Xt3Va5vvnztVutScyZSyQxbKDC9GPRgQNRDXzHaKl3VXCxZD8ZAXdNWaCV4I2gvYFHVmjW1bkTfQMPPi7envWPwdxPEJA_5D_lo5cBPUVbtctEy3tRtRpsTqoOPMcAgx4AHFR4ko_IoVO7lk1B5FCppJbPQPHjxmDH1BzD_xp4MZuDDCYB86T1CkFEjOA0GA-gkjcf_ZfwFebi6Pg</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Cramm, Shannon L.</creator><creator>Graham, Dionne A.</creator><creator>Blakely, Martin L.</creator><creator>Chandler, Nicole M.</creator><creator>Cowles, Robert A.</creator><creator>Kunisaki, Shaun M.</creator><creator>Russell, Robert T.</creator><creator>Allukian, Myron</creator><creator>DeFazio, Jennifer R.</creator><creator>Griggs, Cornelia L.</creator><creator>Santore, Matthew T.</creator><creator>Scholz, Stefan</creator><creator>Aronowitz, Danielle I.</creator><creator>Campbell, Brendan T.</creator><creator>Collins, Devon T.</creator><creator>Commander, Sarah J.</creator><creator>Engwall-Gill, Abigail</creator><creator>Esparaz, Joseph R.</creator><creator>Feng, Christina</creator><creator>Gerall, Claire</creator><creator>Hanna, David N.</creator><creator>Keane, Olivia A.</creator><creator>Lamoshi, Abdulraouf</creator><creator>Lipskar, Aaron M.</creator><creator>Orlas Bolanos, Claudia P.</creator><creator>Pace, Elizabeth</creator><creator>Regan, Maia D.</creator><creator>Tracy, Elisabeth T.</creator><creator>Williams, Sacha</creator><creator>Zhang, Lucy</creator><creator>Rangel, Shawn J.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8531-4249</orcidid><orcidid>https://orcid.org/0000-0003-0988-3260</orcidid><orcidid>https://orcid.org/0000-0002-0985-9204</orcidid><orcidid>https://orcid.org/0000-0002-3375-9158</orcidid><orcidid>https://orcid.org/0000-0003-2116-1383</orcidid><orcidid>https://orcid.org/0000-0002-8815-1262</orcidid><orcidid>https://orcid.org/0000-0003-3459-2772</orcidid><orcidid>https://orcid.org/0000-0002-7772-1637</orcidid><orcidid>https://orcid.org/0000-0002-9229-4733</orcidid><orcidid>https://orcid.org/0000-0002-2777-1839</orcidid><orcidid>https://orcid.org/0000-0001-5784-1001</orcidid><orcidid>https://orcid.org/0000-0003-2530-0328</orcidid><orcidid>https://orcid.org/0000-0001-9923-0540</orcidid><orcidid>https://orcid.org/0000-0003-0043-8558</orcidid></search><sort><creationdate>202306</creationdate><title>Outcomes and Resource Utilization Associated with Use of Routine Pre-Discharge White Blood Cell Count for Clinical Decision-Making in Children with Complicated Appendicitis: A Multicenter Hospital-Level Analysis</title><author>Cramm, Shannon L. ; Graham, Dionne A. ; Blakely, Martin L. ; Chandler, Nicole M. ; Cowles, Robert A. ; Kunisaki, Shaun M. ; Russell, Robert T. ; Allukian, Myron ; DeFazio, Jennifer R. ; Griggs, Cornelia L. ; Santore, Matthew T. ; Scholz, Stefan ; Aronowitz, Danielle I. ; Campbell, Brendan T. ; Collins, Devon T. ; Commander, Sarah J. ; Engwall-Gill, Abigail ; Esparaz, Joseph R. ; Feng, Christina ; Gerall, Claire ; Hanna, David N. ; Keane, Olivia A. ; Lamoshi, Abdulraouf ; Lipskar, Aaron M. ; Orlas Bolanos, Claudia P. ; Pace, Elizabeth ; Regan, Maia D. ; Tracy, Elisabeth T. ; Williams, Sacha ; Zhang, Lucy ; Rangel, Shawn J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c315t-1d18aedb5fcfde54fb2107ac243591bedde44075ca53650b5e824c164c65b6e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Appendectomy - methods</topic><topic>Appendicitis</topic><topic>Appendicitis - complications</topic><topic>Appendicitis - surgery</topic><topic>Child</topic><topic>Clinical Decision-Making</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Length of stay</topic><topic>Leukocyte Count</topic><topic>Organ space infection</topic><topic>Patient Discharge</topic><topic>Resource utilization</topic><topic>Retrospective Studies</topic><topic>White blood cell count</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cramm, Shannon L.</creatorcontrib><creatorcontrib>Graham, Dionne A.</creatorcontrib><creatorcontrib>Blakely, Martin L.</creatorcontrib><creatorcontrib>Chandler, Nicole M.</creatorcontrib><creatorcontrib>Cowles, Robert A.</creatorcontrib><creatorcontrib>Kunisaki, Shaun M.</creatorcontrib><creatorcontrib>Russell, Robert T.</creatorcontrib><creatorcontrib>Allukian, Myron</creatorcontrib><creatorcontrib>DeFazio, Jennifer R.</creatorcontrib><creatorcontrib>Griggs, Cornelia L.</creatorcontrib><creatorcontrib>Santore, Matthew T.</creatorcontrib><creatorcontrib>Scholz, Stefan</creatorcontrib><creatorcontrib>Aronowitz, Danielle I.</creatorcontrib><creatorcontrib>Campbell, Brendan T.</creatorcontrib><creatorcontrib>Collins, Devon T.</creatorcontrib><creatorcontrib>Commander, Sarah J.</creatorcontrib><creatorcontrib>Engwall-Gill, Abigail</creatorcontrib><creatorcontrib>Esparaz, Joseph R.</creatorcontrib><creatorcontrib>Feng, Christina</creatorcontrib><creatorcontrib>Gerall, Claire</creatorcontrib><creatorcontrib>Hanna, David N.</creatorcontrib><creatorcontrib>Keane, Olivia A.</creatorcontrib><creatorcontrib>Lamoshi, Abdulraouf</creatorcontrib><creatorcontrib>Lipskar, Aaron M.</creatorcontrib><creatorcontrib>Orlas Bolanos, Claudia P.</creatorcontrib><creatorcontrib>Pace, Elizabeth</creatorcontrib><creatorcontrib>Regan, Maia D.</creatorcontrib><creatorcontrib>Tracy, Elisabeth T.</creatorcontrib><creatorcontrib>Williams, Sacha</creatorcontrib><creatorcontrib>Zhang, Lucy</creatorcontrib><creatorcontrib>Rangel, Shawn J.</creatorcontrib><creatorcontrib>Eastern Pediatric Surgery Network</creatorcontrib><creatorcontrib>Eastern Pediatric Surgery Network</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cramm, Shannon L.</au><au>Graham, Dionne A.</au><au>Blakely, Martin L.</au><au>Chandler, Nicole M.</au><au>Cowles, Robert A.</au><au>Kunisaki, Shaun M.</au><au>Russell, Robert T.</au><au>Allukian, Myron</au><au>DeFazio, Jennifer R.</au><au>Griggs, Cornelia L.</au><au>Santore, Matthew T.</au><au>Scholz, Stefan</au><au>Aronowitz, Danielle I.</au><au>Campbell, Brendan T.</au><au>Collins, Devon T.</au><au>Commander, Sarah J.</au><au>Engwall-Gill, Abigail</au><au>Esparaz, Joseph R.</au><au>Feng, Christina</au><au>Gerall, Claire</au><au>Hanna, David N.</au><au>Keane, Olivia A.</au><au>Lamoshi, Abdulraouf</au><au>Lipskar, Aaron M.</au><au>Orlas Bolanos, Claudia P.</au><au>Pace, Elizabeth</au><au>Regan, Maia D.</au><au>Tracy, Elisabeth T.</au><au>Williams, Sacha</au><au>Zhang, Lucy</au><au>Rangel, Shawn J.</au><aucorp>Eastern Pediatric Surgery Network</aucorp><aucorp>Eastern Pediatric Surgery Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes and Resource Utilization Associated with Use of Routine Pre-Discharge White Blood Cell Count for Clinical Decision-Making in Children with Complicated Appendicitis: A Multicenter Hospital-Level Analysis</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>2023-06</date><risdate>2023</risdate><volume>58</volume><issue>6</issue><spage>1178</spage><epage>1184</epage><pages>1178-1184</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><abstract>The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis.
Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered routine if obtained within one day of discharge in children who did not develop an organ space infection (OSI) or fever during the index admission. Hospital-level observed-to-expected ratios (O/E) for 30-day outcomes (antibiotic days, imaging utilization, healthcare days, and OSI) were calculated after adjusting for appendicitis severity and patient characteristics. Spearman correlation was used to explore the relationship between hospital-level RPD-WBC utilization and O/E's for each outcome.
1528 children were included. Significant variation was found across hospitals in RPD-WBC use (range: 0.7–100%; p < 0.01) and all outcomes (mean antibiotic days: 9.9 [O/E range: 0.56–1.44, p < 0.01]; imaging: 21.9% [O/E range: 0.40–2.75, p < 0.01]; mean healthcare visit days: 5.7 [O/E 0.74–1.27, p < 0.01]); OSI: 14.1% [O/E range: 0.43–3.64, p < 0.01]). No correlation was found between RPD-WBC use and antibiotic days (r = +0.14, p = 0.64), imaging (r = −0.07, p = 0.82), healthcare days (r = +0.35, p = 0.23) or OSI (r = −0.13, p = 0.65).
Increased RPD-WBC utilization in pediatric complicated appendicitis did not correlate with improved outcomes or resource utilization at the hospital level.
III.
Clinical Research</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37030979</pmid><doi>10.1016/j.jpedsurg.2023.02.039</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8531-4249</orcidid><orcidid>https://orcid.org/0000-0003-0988-3260</orcidid><orcidid>https://orcid.org/0000-0002-0985-9204</orcidid><orcidid>https://orcid.org/0000-0002-3375-9158</orcidid><orcidid>https://orcid.org/0000-0003-2116-1383</orcidid><orcidid>https://orcid.org/0000-0002-8815-1262</orcidid><orcidid>https://orcid.org/0000-0003-3459-2772</orcidid><orcidid>https://orcid.org/0000-0002-7772-1637</orcidid><orcidid>https://orcid.org/0000-0002-9229-4733</orcidid><orcidid>https://orcid.org/0000-0002-2777-1839</orcidid><orcidid>https://orcid.org/0000-0001-5784-1001</orcidid><orcidid>https://orcid.org/0000-0003-2530-0328</orcidid><orcidid>https://orcid.org/0000-0001-9923-0540</orcidid><orcidid>https://orcid.org/0000-0003-0043-8558</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-3468 |
| ispartof | Journal of pediatric surgery, 2023-06, Vol.58 (6), p.1178-1184 |
| issn | 0022-3468 1531-5037 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2798713647 |
| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Anti-Bacterial Agents - therapeutic use Antibiotics Appendectomy - methods Appendicitis Appendicitis - complications Appendicitis - surgery Child Clinical Decision-Making Hospitals Humans Length of stay Leukocyte Count Organ space infection Patient Discharge Resource utilization Retrospective Studies White blood cell count |
| title | Outcomes and Resource Utilization Associated with Use of Routine Pre-Discharge White Blood Cell Count for Clinical Decision-Making in Children with Complicated Appendicitis: A Multicenter Hospital-Level Analysis |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T20%3A12%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Outcomes%20and%20Resource%20Utilization%20Associated%20with%20Use%20of%20Routine%20Pre-Discharge%20White%20Blood%20Cell%20Count%20for%20Clinical%20Decision-Making%20in%20Children%20with%20Complicated%20Appendicitis:%20A%20Multicenter%20Hospital-Level%20Analysis&rft.jtitle=Journal%20of%20pediatric%20surgery&rft.au=Cramm,%20Shannon%20L.&rft.aucorp=Eastern%20Pediatric%20Surgery%20Network&rft.date=2023-06&rft.volume=58&rft.issue=6&rft.spage=1178&rft.epage=1184&rft.pages=1178-1184&rft.issn=0022-3468&rft.eissn=1531-5037&rft_id=info:doi/10.1016/j.jpedsurg.2023.02.039&rft_dat=%3Cproquest_cross%3E2798713647%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c315t-1d18aedb5fcfde54fb2107ac243591bedde44075ca53650b5e824c164c65b6e63%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2798713647&rft_id=info:pmid/37030979&rfr_iscdi=true |