54 Postoperative emergency department presentations following paediatric G-tube placement
Notice bibliographique
Résumé
Abstract Background As children with complex medical needs live longer, adequate nutrition, especially in those with neurological impairments, is increasingly crucial. Gastrostomy tube (G-tube) placement is common in paediatric surgery but often leads to complications, such as tube dislodgement and skin irritation, resulting in high post-operative emergency department (ED) visits. In a U.S. study, 28.9% of children needed unplanned hospital care within 30 days post-G-tube placement. In Canada, paediatric G-tube-related ED visits add to the severe overcrowding, reducing care quality and safety. Objectives The objective of this study was to assess the frequency of ED visits among paediatric patients who underwent operative G-tube placement in Nova Scotia within a 90-day timeframe. Our specific goals included identifying the primary reasons for these presentations and evaluating the prevalence of ED visits that could potentially have been avoided with appropriate care interventions. Design/Methods This study is a retrospective review of all paediatric patients who had a surgically placed G-tube at the IWK between April 1, 2016, and March 31, 2022, and then presented to a Nova Scotia ED within 90 days of their surgery. Chart review was performed after identifying patients using provincial and national databases. Patient demographics, surgical variables, and details from the ED visit (reason for presentation, diagnosis, disposition) were abstracted. Results During the study period, 125 patients underwent surgical g-tube placement and 53.6% (N=67) presented to the ED at least once within 90 days of their surgery. 56.9% of ED visits were for medical reasons unrelated to the primary surgery while 43.1% were surgically related. 63% of patients were discharged home and 30.8% required hospital admissions. Of those admitted, 20% were related to the g-tube surgery. Tube dislodgement was the most common complication, making up 24.6% of ED visits in 90 days. Superficial surgical site infection (SSI) and granulation tissue were the second most common postoperative complications, making up 13.9% of ED visits. Conclusion In Nova Scotia, ED utilization is high in children with gastrostomy tubes, for both medical reasons and those related directly to the operation. Tube dislodgement and superficial SSI were found to be the most common complication. Investigation into possible outpatient resources to manage these common postoperative issues could significantly decrease ED utilization and improve patient care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».