Lee Chia-Hsuan, Hsu Wei-Chung, Ko Jenq-Yuh, Yeh Te-Huei, Chang Wei-Hsiu, Kang Kun-Tai
a Department of Otolaryngology , Taipei Hospital, Ministry of Health and Welfare , New Taipei City , Taiwan.
b Department of Otolaryngology , National Taiwan University Hospital , Taipei , Taiwan.
Acta Otolaryngol. 2017 Dec;137(12):1265-1270. doi: 10.1080/00016489.2017.1357191. Epub 2017 Jul 27.
To assess population-level data for pediatric adenoidectomy.
Using data from the Taiwan National Health Insurance Research Database for the 1997-2012 period, all inpatients <18 years who received adenoidectomies were identified by codes from the International Classification of Diseases, 9th Revision.
A total of 20,599 children underwent adenoidectomy (mean age, 7.4 years; 67% boys). The overall incidence rate was 24.5 per 100,000 children. The highest incidence was observed for the ages of 3-5 years in both genders (p < .001). Boys exhibited higher incidence rates than did girls (p < .001). Longitudinal data revealed an increase in the incidence rates from 1997 (14.8/100,000) to 2012 (26.9/100,000) (p trend < .001). The proportion of adenoidectomies performed at medical centers decreased from 60.5 to 46.9%, whereas those performed at regional hospitals increased from 36.4 to 47.2% (all p trend < .001). The proportion of pediatric adenoidectomies performed for sleep-disordered breathing (SDB) increased significantly from 10.1 to 35.6%, whereas those for infections decreased from 32.3 to 8.0% (all p trend < .001).
This study revealed an increasing trend of pediatric inpatient adenoidectomy incidence rates during 1997-2012 in Taiwan. Moreover, surgical indications have shifted from infections to SDB.
评估儿童腺样体切除术的人群水平数据。
利用1997 - 2012年台湾国民健康保险研究数据库的数据,通过国际疾病分类第九版编码识别所有接受腺样体切除术的18岁以下住院患者。
共有20599名儿童接受了腺样体切除术(平均年龄7.4岁;67%为男孩)。总体发病率为每10万名儿童24.5例。在3 - 5岁年龄段,男女发病率均最高(p <.001)。男孩的发病率高于女孩(p <.001)。纵向数据显示,发病率从1997年的14.8/10万上升至2012年的26.9/10万(p趋势<.001)。在医学中心进行的腺样体切除术比例从60.5%降至46.9%,而在区域医院进行的比例从36.4%升至47.2%(所有p趋势<.001)。因睡眠呼吸障碍(SDB)进行的儿童腺样体切除术比例从10.1%显著增至35.6%,而因感染进行的比例从32.3%降至8.0%(所有p趋势<.001)。
本研究揭示了1997 - 2012年台湾儿童住院腺样体切除术发病率呈上升趋势。此外,手术适应症已从感染转向SDB。