Department of Head and Neck Surgery, The Permanente Medical Group, San Francisco, California, USA.
Otolaryngol Head Neck Surg. 2014 Apr;150(4):574-81. doi: 10.1177/0194599813519972.
To provide information on the prevalence of common complications of adult tonsillectomy and associated health care utilization and expenditures.
Retrospective analysis of a large insurance database.
Data from the MarketScan Commercial Claims and Encounters Database.
Treated prevalence rates for post-tonsillectomy complications were calculated for 36,210 patients with employer-sponsored insurance who had an outpatient tonsillectomy between 2002 and 2007. The relationships with various patient characteristics were examined using multivariate logistic regression. Postoperative emergency department (ED) visits and hospitalizations and total per capita health care expenditures were analyzed.
This analysis suggests that of adult patients who undergo a tonsillectomy, 20% will have a complication, 10% will visit an ED, and approximately 1.5% will be admitted to a hospital within 14 days of the tonsillectomy. Six percent were treated for postoperative hemorrhage, 2% for dehydration, and 11% for ENT pain within 14 days of surgery. Patients with comorbidities, prior peritonsillar abscess, or an increased number of antibiotic prescriptions in the past year were significantly more likely to develop complications. Three out of 4 patients with postoperative hemorrhage went to the ED (4.63% of all patients), and 50% had a procedural intervention (3.09% overall). The average cost associated with a tonsillectomy was $3832 if no complication. If there was a complication within 14 days, hemorrhage was the most expensive ($6388 vs $5753 for dehydration and $4708 for ENT pain).
Complications of adult outpatient tonsillectomies are common and may be associated with significant morbidity, health care utilization, and expenditures.
提供成人扁桃体切除术常见并发症及其相关医疗保健利用和支出的流行情况信息。
对大型保险数据库进行回顾性分析。
来自 MarketScan 商业索赔和就诊数据库的数据。
对 2002 年至 2007 年间接受门诊扁桃体切除术的 36210 名有雇主赞助保险的患者进行了扁桃体切除术后并发症的治疗患病率计算。使用多变量逻辑回归检查了与各种患者特征的关系。分析了术后急诊就诊和住院情况以及人均医疗保健支出。
该分析表明，在接受扁桃体切除术的成年患者中，有 20%会出现并发症，10%会去急诊就诊，约 1.5%会在扁桃体切除术后 14 天内住院。术后 6%因出血、2%因脱水、11%因 ENT 疼痛在术后 14 天内接受治疗。有合并症、过去有扁桃体周围脓肿或过去一年中抗生素处方增加的患者发生并发症的风险显著增加。每 4 例术后出血患者中就有 3 例（占所有患者的 4.63%）去了急诊，其中 50%进行了手术干预（占总数的 3.09%）。如果在 14 天内没有并发症，扁桃体切除术的平均费用为 3832 美元。如果在 14 天内发生并发症，出血是最昂贵的（脱水的费用为 6388 美元，比 ENT 疼痛的费用 5753 美元高，ENT 疼痛的费用为 4708 美元）。
成人门诊扁桃体切除术的并发症很常见，可能与显著的发病率、医疗保健利用和支出有关。
