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Poster - 23
Revisiting the Turkish Esophageal Atresia Registry for Quality Indicators
T Soyer*, SA Bostancı**, Ç Ulukaya Durakbaşa***, C Özcan****, İ Çiftçi*****, G Göllü******, A Parlak*******, EB Çığşar Kuzu********, BD Demirel*********, OD Ayvaz**********, B Fırıncı***********, A Şencan************, A Temiz*************, E Özçakır**************, S Özaydın***************
*Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkiye
**Ankara Bilkent City Hospital Department of Pediatric Surgery, Ankara
***Istanbul Medeniyet University Faculty of Medicine Department of Pediatric Surgery
****Department of Pediatric Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
*****Department of Pediatric Surgery, Selçuk University School of Medicine, Konya, Turkey
******Ankara University Faculty of Medicine, Department of Pediatric Surgery, Ankara
*******Bursa Uludag University, Faculty of Medicine, Department of Pediatric Surgery
********Department of Pediatric Surgery, İzmir Katip Çelebi University School of Medicine, İzmir, Turkey
*********Ondokuz Mayıs University department of Pediatric Surgery
**********Health Sciences University, Turkey. Istanbul Zeynep Kamil Maternity and Children's Disease Health Training and Research Center, Department of the Pediatric Surgery, Istanbul
***********Ataturk University School of Medicine, Department of Pediatric Surgery, Erzurum
************Dr. Behçet Uz Child Diseases and Surgery Training and Research Hospital, Pediatric Surgery Clinic
*************Baskent University Faculty of Medicine Department of Pediatric Surgery
**************Bursa Health Sciences University, Yuksek Ihtisas Education and Research Hospital, Department of Pediatric Surgery, Bursa, Turkey.
***************Kanuni Education and Research Hospital, Department of Pediatric Surgery
Aim: The Turkish Esophageal Atresia Registry (TEAR) data revisited for quality indicators (QI) to evaluate quality care of patients with esophageal atresia (EA).
Methods: Among 36 centers registering data in the TEAR database, centers with more than 4 patients per year were invited. According to defined QI, each centers data was evaluated for structural indicators (use of bronchoscopy, having multidisciplinary team and transition to adulthood facilities) and outcome indicators (percent of anastomosis leaks, strictures, refistulization, reoperation, diagnosed gastroesophageal reflux (GER), postoperative and intraoperative complications). The mean percent of each indicator was defined and centers with lower-than-average percentages were determined as ‘meeting that quality indicator’, while those with higher percentages were determined as ‘not meeting’ for outcome indicators.
Results: Fifteen centers invited to study including data of 713 patients. 80% of centers have multidisciplinary teams, 33% of them had follow-up program for transition to adulthood. The mean percent of the QI was; preoperative bronchoscopy 29.9%, intraoperative complications 4.6%, anastomotic leaks 7.7%, strictures 39%, reoperation 5.2%, refistulizaiton 4.3%, defined GER 16,2%, postoperative complications 2.8% and mortality 9.4%. One center met the 91% of the QI, whereas, 2 centers met the 82% of them and 3 of them met 73% of QI. Two centers met only 36% of the indicators. The most met QI was multidisciplinary teams and intraoperative complications (n=12, 80%) whereas anastomotic strictures was the least (n=6, 40%). No correlation was found between the number of patients in the centers and the number of QI met (p>0.05).
Conclusions: QI allow centers providing insight to their EA care and compare it with other centers.