Abstract：
BACKGROUND/PURPOSE:Trauma centers (TC) are certified based on widely accepted criteria. These specific criteria rarely are scrutinized individually. The purpose of this study was to analyze the individual components of a pediatric trauma center for their effect on outcome. METHODS:Members of the National Pediatric Trauma Registry were queried about the following: (1) separate pediatric emergency department (ED), (2) pediatric intensive care unit (PICU), (3) pediatric intensivist as PICU director, (4) pediatric surgeon as TC director, (5) in-house attending surgeon, (6) in-house pediatric emergency physician, (7) 24-hour operating room, (8) 24-hour computed tomography (CT) scan. Outcomes analyzed included mortality, length of stay, time in ED, days in PICU, and disability. Victims were stratified based on age (<7 or > or = 7 years) and severity of injury (ISS < or = 16, 17-35, > or = 36). Results were compared using Student's t test and chi2 analysis. RESULTS:A total of 59 of 74 centers responded, 18 were dropped because of low enrollment (mean, 1.6 patients). Questions 3, 4, 6, and 7 were eliminated because of skewed data. An in-house surgeon reduced the amount of time a mildly injured patient (ISS < or = 16) spent in the ED (210 v434 minutes), as did the separate pediatric ED (333 v592 minutes) and pediatric emergency physicians (344 v 507 minutes) in younger patients (> or = 7 years). An in-house surgeon reduced the morality rate in older (> or = 7) severely injured (ISS > or = 36) patients (46.7% v 56.8%; P < .05 for all). No other differences were significant. CONCLUSIONS:In-house personnel improved efficiency for the less severely injured, and an in-house attending surgeon reduced mortality in the severely injured older patient. None of the other variables were found to have a significant impact on outcome.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Doolin EJ,Browne AM,DiScala Cdoi
10.1016/s0022-3468(99)90392-5subject
Has Abstractpub_date
1999-05-01 00:00:00pages
885-9; discussion 889-90issue
5eissn
0022-3468issn
1531-5037pii
S0022-3468(99)90392-5journal_volume
34pub_type
杂志文章,多中心研究abstract：:Enterocolitis (EC) remains the most serious complication of Hirschsprung's disease (HD). The aetiology of EC is uncertain. Ischemic and bacterial causes, and recently rotavirus infection, have been suggested to explain the occurrence of EC. The gut has an abundance of neuroendocrine (NE) cells which modulate gut funct...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90520-u
更新日期：1993-08-01 00:00:00
abstract：OBJECTIVES:To assess outcomes of unilateral multicystic dysplastic kidney (MCDK) managed at an Australasian centre over a 15 year period. To assess if MCDK involution could be predicted based on change noted between first two postnatal ultrasound scans 6 months apart. SUBJECTS AND METHODS:A retrospective study was per...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.12.008
更新日期：2020-11-01 00:00:00
abstract：PURPOSE:There is a paucity of quantitative and reproducible follow-up data on childhood operations for gastroesophageal reflux disease (GERD). With the development of minimally invasive techniques for antireflux operations in children, there is a need to quantitatively determine immediate outcomes for such operations p...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90594-2
更新日期：1998-11-01 00:00:00
abstract：:Twenty-one pediatric cases of abdominal cystic lymphangioma (CL) treated in the past 20 years are reviewed. To date, this is the largest reported series. CL is a rare congenital malformation that presents either with chronic abdominal distension (and is detected by palpation of a cystic mass) or acutely with bowel obs...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90673-9
更新日期：1996-05-01 00:00:00
abstract：:As a result of our experience and a review of the literature, early investigation by endoscopic retrograde cholangiopancreaticography (ERCP) and surgical intervention is recommended in chronic relapsing pancreatitis in childhood. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90905-9
更新日期：1991-02-01 00:00:00
abstract：BACKGROUND/PURPOSE:Deterioration of long-term enteral access devices remains a significant patient care and financial problem. Because it is known that lipids, particularly medium-chain triglycerides oil (MCT oil), can soften and break certain types of polymeric materials, the authors evaluated the effect of liquid ent...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90665-0
更新日期：1998-06-01 00:00:00
abstract：:Rhabdomyoma is a rare benign tumor of striated muscle origin. Two distinct histologic groups, adult and fetal type, are recognized. So far only 66 cases of extracardiac rhabdomyomas (37 fetal and 29 adult) have been documented in the literature reviewed. The present report details a case of adult rhabdomyoma of the es...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(87)80490-6
更新日期：1987-11-01 00:00:00
abstract：BACKGROUND:Investigation of the value of scrotal Doppler ultrasound (DUS) in the diagnosis of acute scrotum and its impact on the treatment strategy was undertaken. METHOD:Seventy-nine children (mean age, 9.2 years) with acute scrotum were prospectively studied. The protocol included history, clinical examination, scr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.04.026
更新日期：2006-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:Chylothorax is a frequent complication in congenital diaphragmatic hernia (CDH) infants and is associated with significant morbidity. The optimal treatment strategy remains unclear. We hypothesize that octreotide decreases chylous effusions in infants with CDH. METHODS:This is a retrospective study ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2013.05.064
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND:Previous studies of recombinant human thrombin (rThrombin) enrolled adult and adolescent patients. This phase 4, open-label, single-group study was conducted in pediatric patients undergoing synchronous burn wound excision and skin grafting to provide information regarding the safety and immunogenicity of rT...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.05.022
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:Diaphragmatic hernia can be repaired by open or minimally invasive surgery (MIS), although it is unclear which technique has better outcomes. Our objective was to compare the outcomes of these procedures in a systematic review and meta-analysis. METHODS:We sought all publications describing both techniques ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpedsurg.2014.02.049
更新日期：2014-05-01 00:00:00
abstract：:A primary lung abscess due to non type B Hemophilus influenzae was diagnosed in three children who failed to improve after prolonged antibiotic treatment for dense, pneumonic infiltrates. In each instance percutaneous aspiration yielded pure cultures of Hemophilus influenzae, one of which was ampicillin resistant. Bec...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(82)80013-4
更新日期：1982-06-01 00:00:00
abstract：:An original incision has been developed for surgery of the penis. The incision can be used as an alternative to the shaft skin retraction technique. The advantage of the new incision is that one can avoid suture lines on the penis and their accompanying complications. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(81)80825-1
更新日期：1981-12-01 00:00:00
abstract：PURPOSE:Patients with intestinal failure (IF) are known to have impaired absorption of nutrients required for maintenance of skeletal mass. Rates and risk factors of low bone mineral density (BMD) are unknown in pediatric IF patients. METHODS:Following IRB approval, patients with IF having undergone DXA scans were ide...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.10.010
更新日期：2015-01-01 00:00:00
abstract：PURPOSE:Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We develo...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2016.10.036
更新日期：2017-01-01 00:00:00
abstract：:Calcified caval thrombus should be considered in any infant or child where calcifications are noted in the high right retroperitoneal area on plain x-rays of the abdomen. Although typically bullet-shaped in configuration, the calcium distribution in the neonate may be atypical or incompletely developed, suggesting neu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(78)80471-0
更新日期：1978-08-01 00:00:00
abstract：:In eight cases of congenital dilatation of the bile duct encountered in our institution during the past 3 years, jejunal interposition hepaticoduodenostomy was performed following resection of the involved bile duct. This procedure has no serious technical difficulties but appears to have some advantages over conventi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(83)80366-2
更新日期：1983-10-01 00:00:00
abstract：AIM:Extrahepatic portal vein obstruction (EPVO) is a common cause of portal hypertension in children and can lead to life-threatening bleeding, thrombocytopenia, and coagulation disorders. Mesoportal bypass (MPB) restores normal physiologic portal flow to the liver and corrects portal hypertension. There is, however, l...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.08.019
更新日期：2010-01-01 00:00:00
abstract：:Tubular colonic duplications are exceedingly rare; the "Y"-shaped forms are exceptional. In the absence of associated low vertebral or urogenital malformations (often fistulas), the tubular colonic malformations frequently stay hidden for several years until a complication develops. The authors report a case of a spon...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.26390
更新日期：2001-09-01 00:00:00
abstract：PURPOSE:The purpose of the study was to compare outcomes of pediatric patients with high-risk metastatic neuroblastoma who received radiotherapy (RT) with those of patients who did not. PATIENTS AND METHODS:We reviewed the records of 63 patients with newly diagnosed metastatic neuroblastoma treated at our institution ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.11.003
更新日期：2010-04-01 00:00:00
abstract：PURPOSE:Necrotizing enterocolitis (NEC) in very low birth weight infants is a risk factor for developmental delay. To our knowledge, there are no studies published investigating the neurodevelopmental outcome of patients with NEC comparing surgically treated and conservatively treated patients versus match paired contr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2018.01.006
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Perioperative hypothermia has been shown to increase surgical site infection (SSI) rates in adults. We sought to characterize whether intraoperative hypothermia or hyperthermia is associated with postoperative infections in infants. METHODS:We conducted a retrospective review of patients ≤6 months old who u...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.09.060
更新日期：2020-01-01 00:00:00
abstract：:Disenchantment with available techniques for specific diagnosis of intrathoracic pulmonary lesions in children has led us to explore the usefulness of thoracoscopy. We have performed this technique in nine patients ranging in age from 17 mo to 16 yr. The procedure is performed under intravenous anesthesia with the pat...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(76)90093-2
更新日期：1976-10-01 00:00:00
abstract：:Over a 6-year period, 14 infants with a total of 16 inguinal hernias (IH) underwent transperitoneal closure of the internal ring (TPIR). This was performed through a minilaparotomy, using a purse-string suture placed around the internal ring from within. A difficult inguinal dissection of an edematous and friable sper...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章
doi：10.1016/0022-3468(95)90619-3
更新日期：1995-01-01 00:00:00
abstract：:A 2 1/2-month-old infant presented with a massive hepatomegaly. Ultrasound and computerized tomography showed a large cystic lesion in the right adrenal, small cysts in the left adrenal, and multiple cystic liver metastases. The right adrenal cyst, on excision, turned out to be a cystic neuroblastoma with hemorrhage. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.05.001
更新日期：2007-08-01 00:00:00
abstract：PURPOSE:Urologic complications are an underappreciated sequelae of the mass effect of sacrococcygeal teratoma (SCT) and its resection. The goal of this study was to evaluate the incidence and severity of urologic complications in patients with SCT. METHODS:A retrospective review of patients with a prenatal diagnosis o...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.03.045
更新日期：2011-06-01 00:00:00
abstract：BACKGROUND/PURPOSE:The formation of congenital chordee penis in patients with or without hypospadias is multifactorial and not completely clear. In most cases, after release of all known causes of chordee, "residual" penile curvature can persist. The authors discuss the etiopathogenetic mechanisms of congenital chordee...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2002.35006
更新日期：2002-09-01 00:00:00
abstract：BACKGROUND/PURPOSE:Thyroid nodules are rare in children. The need to uncover malignancy is the most challenging dilemma in management. The aim of this report was to determine whether management of pediatric thyroid nodules has changed in the era of fine-needle aspiration (FNA) cytology. METHODS:Twenty-four children wi...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0022-3468(98)90174-9
更新日期：1998-08-01 00:00:00
abstract：:Two hundred ninety cases of alleged child sexual abuse (CSA) were reported in Edinburgh and the Lothian region over the 7-year period from 1982 through 1988. We have found an increase in the incidence of alleged CSA, which has resulted in greater involvement of the paediatric surgeon. CSA was found to be occurring wit...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(90)90388-p
更新日期：1990-04-01 00:00:00
abstract：BACKGROUND:Infants with parenteral nutrition dependence may develop liver dysfunction and progress to liver failure requiring transplantation. The aspartate aminotransferase-to-platelet ratio index (APRI) has good correlation with liver fibrosis progression in adults. This study applies APRI scoring to parenteral nutri...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.02.098
更新日期：2010-06-01 00:00:00
