Association Between Language, Interpreter Use, and Pediatric Surgical Outcomes.

Background: Inequities exist in pediatric surgical outcomes. Differential outcomes have been identified across racial groups, geography, and socioeconomic standing. However, the association between preferred language, interpreter use, and surgical outcomes is not well-studied in pediatric surgical literature.

Comparative Analysis of Indices for Social Determinants of Health in Pediatric Surgical Populations.

Importance: Conclusions vary substantially among studies examining associations between area-based social determinants of health (SDOH) and pediatric health disparities based on the selected patient population and SDOH index. Most national studies use zip codes, which encompass a wide distribution of communities, limiting the generalizability of findings.

Objectives: To characterize the distributions of composite SDOH indices for pediatric surgical patients within a national sample of academic children's hospitals and to assess SDOH index precision in classifying patients at similar levels of disadvantage.

Health Disparities Research: What Every Pediatric Surgeon Should Know.

While the earliest published health disparity research in the United States dates to 1899, the field was not formally established until the late 20th century. Initially focused on race and ethnicity, the field has broadened to include socioeconomic status. Several measures have been developed to quantify socioeconomic disadvantage, including the Social Vulnerability Index, Area Deprivation Index, and Child Opportunity Index.

Long-term Outcomes Following Thoracoscopic Division of Vascular Rings.

Objectives: We evaluate long-term symptomatic improvement in vascular ring patients who underwent thoracoscopic division at a single quaternary pediatric surgery center.

Methods: All pediatric patients who underwent vascular ring division without Kommerell's diverticulum resection between 01/2007-12/2022 were included. Surgeries were performed by pediatric general and thoracic surgeons.

Debunking Myths of Gender Informed Care: What Every Pediatric Surgeon Should Know.

As the transgender population in the United States grows, gender-affirming care is becoming increasingly relevant to the practice of pediatric surgery. Medical care for the transgender and gender diverse population is a politically charged topic with significant complexity and opportunities for clarification. It is important for providers to better understand this population's unique health and social needs.

General Care Considerations for the Pediatric Trauma Patient.

Trauma is a leading cause of morbidity and mortality for children in the United States. Access to trauma care, injury burden, and outcomes following injury, are inequitable. There are many anatomic and physiologic differences between children and adults that affect injury patterns and necessary trauma treatment.

Views of American Pediatric Surgeons on Diversity, Equity, and Inclusion.

Introduction: Diversity, Equity, and Inclusion (DEI) are concepts common in surgery. However, these can be difficult to define, and what constitutes DEI can be vague. Closing this knowledge gap, particularly within pediatric surgery, would be helpful to understand the views and needs of current surgeons.

Project SPRUCE: Saving Our Planet by Reducing Carbon Emissions, a Pediatric Anesthesia Sustainability Quality Improvement Initiative.

Background: Children are particularly vulnerable to adverse health outcomes related to climate change. Inhalational anesthetics are potent greenhouse gasses (GHGs) and contribute significantly to health care-generated emissions. Desflurane and nitrous oxide have very high global warming potentials.

Implementation of a Cryoablation-based Pain Management Protocol for Pectus Excavatum.

Introduction: The Nuss repair for pectus excavatum is associated with significant postoperative pain. Our institution developed protocols to standardize pain management for pectus excavatum patients in the immediate postoperative period. We present our experience with protocol implementation and patient outcomes.

Geographic access to care and pediatric surgical outcomes.

Introduction: Rurality and distance traveled for healthcare are associated with worse pediatric health indicators.

Methods: We retrospectively analyzed patients ages 0-21 at a quaternary pediatric surgical facility with a large rural catchment area between 1/1/2016-12/31/2020. Patient addresses were designated as metropolitan or non-metropolitan.

The intersection of pediatric surgery, climate change, and equity.

Climate change is occurring at an unprecedented rate. Recent years have seen heatwaves, wildfires, floods, droughts, and re-emerging infectious diseases fueled by global warming. Global warming has also increased the frequency and severity of surgical disease, particularly for children, who bear an estimated 88% of the global burden of disease attributable to climate change.

Socioeconomic disadvantage and pediatric surgical outcomes.

Introduction: The impact of socioeconomic status on surgical outcomes has not been well-studied in children. Area Deprivation Index (ADI) is a validated measure of neighborhood-level socioeconomic disadvantage.

Methods: A retrospective analysis of surgical patients ages 0-21 years was performed at a quaternary pediatric hospital from 1/1/2016-12/31/2020.

Understanding Hispanic Patient Satisfaction with Telehealth During COVID-19.

Background: Recent studies have described the use of telehealth for pediatric surgical care during the COVID-19 pandemic. We aimed to evaluate equity in telehealth use by comparing rates of utilization and satisfaction with pediatric surgical telemedicine among Hispanic patients.

Methods: We conducted a retrospective cohort study of patients seen by a surgical subspecialty provider in the outpatient setting at a quaternary pediatric hospital between April 1 and June 30, 2020.

The Global Initiative for Children's Surgery: conception, gestation, and delivery.

More than two thirds of the global population lack access to safe, affordable surgical and anesthesia care. This inequity disproportionately affects children in low- and middle-income countries (LMIC). In 2016, a group of pediatric surgical care providers founded the Global Initiative for Children's Surgery (GICS).

Diversity and demographics of APSA members: Understanding our identity.

Introduction: There are existing healthcare disparities in pediatric surgery today. Identity and racial incongruity between patients and providers contribute to systemic healthcare inequities and negatively impacts health outcomes of minoritized populations. Understanding the current demographics of the American Pediatric Surgical Association and therefore the cognitive diversity represented will help inform how best to strategically build the organization to optimize disparity solutions and improve patient care.

APSA Members experience bias and discrimination in training and practice.

Introduction: Bias and discrimination remain pervasive in the medical field and increase the risk of burnout, mental health disorders, and medical errors. The experiences of APSA members with bias and discrimination are unknown, therefore the APSA committee on Diversity, Equity and Inclusion conducted a survey to characterize the prevalence of bias and discrimination.

Methods: 1558 APSA members were sent an anonymous survey, of which 423 (27%) responded.

Population Density and Triage of Pediatric Firearm Injuries in a Rural Trauma System.

Background: Rural pediatric firearm injuries require regional pediatric and trauma expertise. We evaluated county-level population density associations with transport, hospital interventions, and patient outcomes at a Level I pediatric trauma center serving a rural, statewide catchment area.

Material And Methods: The trauma registry of the only in-state pediatric trauma center was reviewed for firearm injuries in patients < 18 between 1/2013 and 3/2020.

Environmental impact of telehealth use for pediatric surgery.

Background: The healthcare sector is responsible for 10% of US greenhouse gas emissions. Telehealth use may decrease healthcare's carbon footprint. Our institution introduced telehealth to support SARS-CoV-2 social distancing.

Magnetic resonance imaging of children following esophageal button battery removal: What are we looking for?

Despite society recommendations that cross-sectional imaging be obtained following removal of ingested button batteries, there is no published consensus on how it effectively guides clinical management. This single institution survey demonstrates a lack of uniformity by clinicians regarding which imaging findings impact management decisions, highlighting the need for further guidelines.

Better together: a reappraisal of heterotopic heart transplantation.

Heterotopic heart transplantation (HHT) is rare in the modern era. When used as a biologic left ventricular assist, HHT provides pulsatile flow, supports the left ventricle with a physiologic cardiac output, responds to humoral stimuli, and with modern immunosuppression may offer long-term untethered survival. This study was undertaken to compare survival of HHT with orthotopic heart transplantation (OHT) to assess its viability in the modern era.

Burkitt Lymphoma Presenting as Perforated Appendicitis.

Appendicitis is the most common indication for an emergent abdominal operation in the pediatric population. Fewer than .015% of patients who undergo appendectomy for presumed appendicitis are diagnosed with primary lymphoma after evaluation of pathology specimen.