Inpatients hypospadias care: Trends and outcomes from the American nationwide inpatient sample
Meyer Christian, Sukumar Shyam, Sood Akshay, Hanske Julian, Vetterlein Malte, Elder Jack S., Fisch Margit, Trinh Quoc-Dien, Friedman Ariella A.,
소속 상세정보
( Meyer Christian )
Harvard Medical School Brigham and Women’s Hospital Division of Urologic Surgery and Center for Surgery and Public Health
( Sukumar Shyam )
Henry Ford Health System Vattikuti Urology Institute
( Sood Akshay )
Henry Ford Health System Vattikuti Urology Institute
( Hanske Julian )
Ruhr University Bochum Department of Urology
( Vetterlein Malte )
University Medical Center Hamburg-Eppendorf Department of Urology
( Elder Jack S. )
Henry Ford Health System Vattikuti Urology Institute
( Fisch Margit )
University Medical Center Hamburg-Eppendorf Department of Urology
( Trinh Quoc-Dien )
Harvard Medical School Brigham and Women’s Hospital Division of Urologic Surgery and Center for Surgery and Public Health
( Friedman Ariella A. )
Henry Ford Health System Vattikuti Urology Institute
KMID : 0358320150560080594
Abstract
Purpose: Hypospadias is the most common congenital penile anomaly. Information about current utilization patterns of inpatient hypospadias repair as well as complication rates remain poorly evaluated.
Materials and Methods: The Nationwide Inpatient Sample was used to identify all patients undergoing inpatient hypospadias repair between 1998 and 2010. Patient and hospital characteristics were attained and outcomes of interest included intra- and immediate postoperative complications. Utilization was evaluated temporally and also according to patient and hospital characteristics. Predictors of complications and excess length of stay were evaluated by logistic regression models.
Results: A weighted 10,201 patients underwent inpatient hypospadias repair between 1998 and 2010. Half were infants (52.2%), and were operated in urban and teaching hospitals. Trend analyses demonstrated a decline in incidence of inpatient hypospadias repair (estimated annual percentage change, -6.80%; range, -0.51% to -12.69%; p=0.037). Postoperative complication rate was 4.9% and most commonly wound-related. Hospital volume was inversely related to complication rates. Specifically, higher hospital volume (>31 cases annually) was the only variable associated with decreased postoperative complications.
Conclusions: Inpatient hypospadias repair have substantially decreased since the late 1990’s. Older age groups and presumably more complex procedures constitute most of the inpatient procedures nowadays.
키워드
Hypospadias ; Inpatients ; Outcome assessment ; Postoperative complications
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