Tumin Dmitry, Hayes Don, Kirkby Stephen E, Tobias Joseph D, McKee Christopher
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, United States.
Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, United States.
Int J Pediatr Otorhinolaryngol. 2017 Jul;98:25-28. doi: 10.1016/j.ijporl.2017.04.034. Epub 2017 Apr 24.
Data on the safety of endoscopic sinus surgery (ESS) are limited in children with cystic fibrosis (CF). We used a multi-institutional surgical registry to examine ESS outcomes in children with CF.
The 2014-2015 American College of Surgeons' National Surgical Quality Improvement Program-Pediatric database was queried for patients age <18 years undergoing elective ESS. Prolonged hospital stay (>1 day), 30-day readmission, and 30-day unplanned reoperation were compared according to presence of CF diagnosis.
The data included 213 children with CF (age 10 ± 5 years, 105/108 male/female) and 821 children without CF (age 10 ± 5 years, 504/317 male/female). CF patients were more likely than non-CF patients to require prolonged hospital stay (30% vs. 9%, p < 0.001), yet had similar rates of readmission (6% vs. 4%; p = 0.189) and reoperation (0 vs. 1%; p = 0.133). All readmissions but one among CF patients were unrelated to ESS. In the non-CF cohort, reasons for ESS-related readmissions included recurrence of sinusitis, postoperative pain, and bleeding.
We demonstrate the safety of ESS in the largest cohort of children with CF reviewed to date. Multi-institutional review of ESS safety may contribute to monitoring expansion of this intervention in children with CF.
关于囊性纤维化(CF)患儿内镜鼻窦手术(ESS)安全性的数据有限。我们使用了一个多机构手术登记系统来研究CF患儿的ESS手术结果。
查询2014 - 2015年美国外科医师学会国家外科质量改进计划 - 儿科数据库,以获取年龄小于18岁接受择期ESS手术的患者信息。根据是否存在CF诊断,比较延长住院时间(>1天)、30天再入院率和30天非计划再次手术率。
数据包括213名CF患儿(年龄10±5岁,男105例/女108例)和821名非CF患儿(年龄10±5岁,男504例/女317例)。CF患者比非CF患者更有可能需要延长住院时间(30%对9%,p<0.001),但再入院率(6%对4%;p = 0.189)和再次手术率(0对1%;p = 0.133)相似。CF患者中除1例之外的所有再入院情况均与ESS无关。在非CF队列中,ESS相关再入院的原因包括鼻窦炎复发、术后疼痛和出血。
我们证明了ESS在迄今为止所审查的最大规模CF患儿队列中的安全性。对ESS安全性的多机构审查可能有助于监测该干预措施在CF患儿中的推广应用。