{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T17:04:58Z","timestamp":1785863098847,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,23]],"date-time":"2018-11-23T00:00:00Z","timestamp":1542931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Pediatric National Surgical Quality Improvement Program (P\u2010<jats:styled-content style=\"fixed-case\">NSQIP<\/jats:styled-content>) samples surgical procedures for benchmarking and quality improvement. While generally comprehensive, P\u2010<jats:styled-content style=\"fixed-case\">NSQIP<\/jats:styled-content> does not collect intraoperative physiologic data, despite potential impact on outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aims of this study were (a) to describe a methodology to augment P\u2010<jats:styled-content style=\"fixed-case\">NSQIP<\/jats:styled-content> with vital signs data and (b) demonstrate its utility by exploring relationships that intraoperative hypothermia and hypotension have with P\u2010<jats:styled-content style=\"fixed-case\">NSQIP<\/jats:styled-content> outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Vital signs from 2012 to 2016 were available in a research databank. Episodes of hypotension and hypothermia were extracted and recorded alongside local P\u2010<jats:styled-content style=\"fixed-case\">NSQIP<\/jats:styled-content> data. Multivariable regression analyses were performed to explore associations with undesired outcomes, including: surgical site infection, wound disruption, unplanned return to the operating room, and blood transfusion. Model variables were selected with the Akaike information criterion using 2012\u20102014 as the training set and validated with receiver operating characteristics analysis using 2015\u20102016 as the testing set.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 6737 patients were analyzed, with 43.9% female, median [interquartile range] age 5.8 [1.3\u201012.4]\u00a0years, undergoing procedures lasting 118 [75\u2010193]\u00a0minutes. Hypothermia, observed in 45% of cases, was associated with wound disruption (odds ratio 1.75, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1\u20102.83). Hypotension, observed in 60% of cases, was associated with unplanned returns (odds ratio 1.58, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.02\u20102.51), and transfusions (odds ratio 1.95, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.14\u20103.52). Surgical site infection, wound disruption, unplanned return, and transfusion models had areas under the receiver operating characteristic curve of 0.69\/0.67, 0.59\/0.63, 0.78\/0.79, and 0.92\/0.93 for validation models including hypothermia\/hypotension respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adding intraoperative vital signs to P\u2010<jats:styled-content style=\"fixed-case\">NSQIP<\/jats:styled-content> data allowed identification of two modifiable risk factors: hypothermia was associated with increased wound\u00a0disruption, and hypotension with increased blood transfusions and unplanned returns to the operating room. These findings may motivate prospective studies and\u00a0prompt other centers and P\u2010<jats:styled-content style=\"fixed-case\">NSQIP<\/jats:styled-content> to augment outcome data with intraoperative physiological data.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.13531","type":"journal-article","created":{"date-parts":[[2018,10,22]],"date-time":"2018-10-22T21:41:22Z","timestamp":1540244482000},"page":"27-37","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Integrating intraoperative physiology data into outcome analysis for the <scp>ACS<\/scp> Pediatric National Surgical Quality Improvement Program"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2193-178X","authenticated-orcid":false,"given":"Matthias","family":"G\u00f6rges","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Pharmacology &amp; Therapeutics University of British Columbia (UBC) Vancouver Canada"},{"name":"Research Institute BC Children's Hospital (BCCH) Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7491-0304","authenticated-orcid":false,"given":"Kourosh","family":"Afshar","sequence":"additional","affiliation":[{"name":"Department of Urologic Sciences UBC Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8382-5136","authenticated-orcid":false,"given":"Nicholas","family":"West","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology &amp; Therapeutics University of British Columbia (UBC) Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Pi","sequence":"additional","affiliation":[{"name":"Department of Statistics UBC Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Bedford","sequence":"additional","affiliation":[{"name":"Department of Quality and Safety BCCH Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8590-3916","authenticated-orcid":false,"given":"Simon D.","family":"Whyte","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology &amp; Therapeutics University of British Columbia (UBC) Vancouver Canada"},{"name":"Research Institute BC Children's Hospital (BCCH) Vancouver Canada"},{"name":"Department of Pediatric Anesthesia BCCH Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.09.073"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2012.10.019"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0867"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.02.047"},{"key":"e_1_2_9_6_1","volume-title":"The Management of Inadvertent Perioperative Hypothermia in Adults","author":"National Collaborating Centre for Nursing and Supportive Care","year":"2008"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/593952"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199605093341901"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182a10e26"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.03140.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12310"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0973"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2008.02.009"},{"key":"e_1_2_9_14_1","unstructured":"MyersD CookeE DunsmuirD BrouseC AnserminoJM.Comparison of absolute and relative rules for identifying hypotension in children during anesthesia. 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