title: Is NSQIP Pediatric review representative of total institutional experience for children undergoing appendectomy?
abstract: OBJECTIVE
  NSQIP Pediatric (NSQIP-P) is a robust quality improvement effort. A limitation of the NSQIP process lies in capturing a small proportion of the total case volume. This study examines whether appendectomies captured by NSQIP-P are concordant with all appendectomies, the most commonly captured procedure in 2011.
  
  
  METHODS
  We compared case mix and 30-day outcomes between children undergoing an appendectomy who were included in NSQIP (n=80) and children not captured by NSQIP (n=276) during 2011 at a tertiary referral children's hospital. A single surgical case reviewer reviewed all cases using NSQIP-P methodology.
  
  
  RESULTS
  NSQIP-P captured 80 of a total of 356 appendectomies (22%). The case mix was similar between NSQIP and non-NSQIP groups (e.g., 31% of each group had complicated appendicitis). Outcomes were also similar; post-operative occurrences, readmissions and return to the operation room occurred at rates of 7.5% vs. 7.6%, 5% vs. 4.7%, and 3.8% vs. 4.3% respectively.
  
  
  CONCLUSIONS
  Although NSQIP-P captured a minority of the total patient population that had an appendectomy, the case mix and outcomes were similar. Our results offer reassurance that NSQIP-P data are representative of the larger population for this procedure. Whether this concordance exists for procedures less commonly performed is unknown and a focus of ongoing work.
authors.affiliation: Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA. Electronic address: Eileen.m.duggan@vanderbilt.edu.
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Duggan
authors.affiliation: Department of Performance Management and Improvement, Monroe Carrell, Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA.
authors.forename: Dan W
authors.initials: DW
authors.lastname: Gates
authors.affiliation: Department of Performance Management and Improvement, Monroe Carrell, Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA.
authors.forename: Jenny M
authors.initials: JM
authors.lastname: Slayton
authors.affiliation: Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Blakely
mesh_terms: D001062:Appendectomy / Q000379:methods / Q000592:standards*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003953:Diagnosis-Related Groups; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007325:Institutional Practice / Q000706:statistics & numerical data*; D010535:Laparoscopy; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology*; D058996:Quality Improvement; D012189:Retrospective Studies; D013714:Tennessee / Q000453:epidemiology
keywords: Appendectomy; NSQIP; Outcomes; Pediatric; Quality