Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Pediatr. 2012 May;160(5):814-9. doi: 10.1016/j.jpeds.2011.11.041. Epub 2011 Dec 17.
To examine geographic and demographic variation for outpatient tonsillectomy in children nationally.
The 2006 National Survey of Ambulatory Surgery was analyzed to describe outpatient tonsillectomy in children. Rates by age, sex, region, urban/rural residence, and payment source were calculated with 2006 population estimates from the Census Bureau and the National Health Interview Survey as denominators. Rates were compared with Z tests.
In 2006, approximately 583 000 (95% CI, 370 000-796 000) outpatient tonsillectomy procedures were performed in children in the United States. Rates per 10 000 children were lower in children 13 to 17 years old (33.8 per 10 000) than in both children 7 to 12 years old (91.3; P < .05) and children 0 to 6 years old (102.9; P < .001). Compared with the South, tonsillectomy rates were lower in the West (29 per 10 000 versus 125 per 10 000; P < .01) and not significantly different in other regions. Compared with large central metropolitan areas, tonsillectomy rates were higher in small/medium metropolitan areas (118 per 10 000 versus 42 per 10 000; P < .05), and not significantly different in large fringe or non-metropolitan areas. Tonsillectomy rates were similar for children insured by Medicaid compared with those insured by private sources. Compared with older children (13-17 years), children in the younger age groups (0-6 years, 7-12 years) underwent tonsillectomy more commonly for airway obstruction (69.5% and 59.2% versus 34.3%, P < .05 for both). Compared with older children, younger children (0-6 years) underwent tonsillectomy less commonly for infection (40.4% versus 61.0% [7-12 years] and 72.2% [13-17 years], P < .001 for both).
Use of tonsillectomy in the ambulatory setting varies across age groups, geographic regions, levels of urbanization, and indication. Further research is warranted to examine these differences.
研究全国范围内儿童门诊扁桃体切除术的地域和人口统计学差异。
对 2006 年全国门诊手术调查进行了分析，以描述儿童门诊扁桃体切除术。根据人口普查局和全国健康访谈调查的 2006 年人口估计数作为分母，计算了按年龄、性别、地区、城乡居住和支付来源划分的扁桃体切除术率。通过 Z 检验比较了这些比率。
2006 年，美国约有 583000 例（95%CI，370000-796000）儿童门诊扁桃体切除术。与 7-12 岁儿童（91.3；P<0.05）和 0-6 岁儿童（102.9；P<0.001）相比，13-17 岁儿童（33.8/10000）的扁桃体切除术率较低。与南部地区相比，西部地区的扁桃体切除术率较低（29/10000 与 125/10000；P<0.01），而其他地区则无显著差异。与大型中心都会区相比，中小都会区的扁桃体切除术率较高（118/10000 与 42/10000；P<0.05），而大型边缘或非都会区则无显著差异。与私人保险相比，接受医疗补助保险的儿童的扁桃体切除术率相似。与年龄较大的儿童（13-17 岁）相比，年龄较小的儿童（0-6 岁，7-12 岁）因气道阻塞而接受扁桃体切除术的比例更高（69.5%和 59.2%与 34.3%，两者均 P<0.05）。与年龄较大的儿童相比，年龄较小的儿童（0-6 岁）因感染而接受扁桃体切除术的比例较低（40.4%与 61.0%[7-12 岁]和 72.2%[13-17 岁]，两者均 P<0.001）。
在门诊环境中使用扁桃体切除术的情况因年龄组、地理区域、城市化水平和适应证而异。需要进一步研究以检查这些差异。
