Six pediatric surgical procedures account for most postoperative hospital and emergency department visits, according to a research letter published in the Aug. 23/30 issue of the Journal of the American Medical Association.
Christopher De Boer, M.D., from the Ann and Robert H. Lurie Children’s Hospital of Chicago, and colleagues examined revisit rates across nine pediatric surgical subspecialties at tertiary care children’s hospitals. The analysis included data from the Pediatric Health Information System (52 tertiary children’s hospitals) on children (aged 18 years and younger) who underwent one of 26 inpatient or ambulatory procedures (1.2 million index procedures) from 2016 to 2020.
The researchers found 88,796 revisits (7.46 percent), of which 43.63 percent were to the emergency department only. The highest number of revisits occurred after tonsillectomy/adenoidectomy (18,279), while central venous catheter (CVC)/port insertion had the highest revisit rate (41.45 percent). The most emergency department-only visits occurred after tonsillectomy/adenoidectomy and appendectomy. Otolaryngology and general pediatric surgery accounted for 77.58 percent of the revisit prevalence and 74.32 percent of the emergency department-only visit prevalence. Six procedures within the otolaryngology and general pediatric surgery specialties (tonsillectomy/adenoidectomy, appendectomy, CVC/port insertion, gastrostomy, myringotomy/tympanostomy, and circumcision) accounted for 67.77 percent of all revisits and 63.08 percent of emergency department-only visits.
“Our study results are also important in that we already know that revisits after children’s surgery take a tremendous financial toll on the health system,” a coauthor said in a statement. “The high levels of revisit rates in just a few procedures present a tremendous opportunity to change how we do the business of children’s surgery.”