Kim Yesul, Patel Vijay A, Isildak Huseyin, Carr Michele M
*College of Medicine †Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania ‡Department of Otolaryngology, West Virginia University, Morgantown, West Virginia.
Otol Neurotol. 2017 Dec;38(10):1426-1432. doi: 10.1097/MAO.0000000000001585.
To determine perioperative morbidity of children ≤12 months undergoing cochlear implantation (CI).
Retrospective analysis using the American College of Surgeons National Surgical Quality Improvement Program Pediatric Database (ACS-NSQIP-P).
General acute care children's hospitals, children's hospitals within larger hospitals, specialty children's hospitals, and general acute care hospitals with a pediatric wing.
Children who underwent CI were queried using the ACS-NSQIP-P from 2012 to 2015.
Cochlear implantation.
Risk factors analyzed include age, prematurity, and presence of congenital disorders. Outcomes analyzed include operative time, length of stay, general surgical complications, readmissions, and related reoperations.
Over the database accrual period, the percentage of children ≤12 months at the time of surgery increased from 2012 to 2015 (6.08-7.78%, p = 0.0752). Total operative time, length of stay (≥1 d), and readmissions for those ≤12 months were significantly greater compared with those >12 months at the time of surgery (p < 0.001, p = 0.0037, and p < 0.0001, respectively). There were no statistically significant differences in general surgical complications (i.e., superficial incisional surgical site infections, organ/space surgical site infections, and/or unplanned reoperations) in cases ≤12 months. Complications specific to CI such as facial nerve paralysis, cerebrospinal fluid leak, and mastoiditis were not recorded in the ACS-NSQIP-P.
Infants had no more general surgical complications in the immediate postoperative period compared with older children, although total operative time, length of stay, and readmissions were found to be significantly greater in frequency.
确定12个月及以下儿童接受人工耳蜗植入（CI）的围手术期发病率。
使用美国外科医师学会国家外科质量改进计划儿科数据库（ACS-NSQIP-P）进行回顾性分析。
普通急症儿童医院、大型医院内的儿童医院、专科儿童医院以及设有儿科病房的普通急症医院。
2012年至2015年期间使用ACS-NSQIP-P查询接受CI的儿童。
人工耳蜗植入。
分析的风险因素包括年龄、早产和先天性疾病的存在。分析的结果包括手术时间、住院时间、一般外科并发症、再入院率和相关再次手术。
在数据库积累期间，手术时12个月及以下儿童的比例从2012年到2015年有所增加（6.08 - 7.78%，p = 0.0752）。手术时12个月及以下儿童的总手术时间、住院时间（≥1天）和再入院率显著高于12个月以上儿童（分别为p < 0.001、p = 0.0037和p < 0.0001）。12个月及以下病例的一般外科并发症（即浅表切口手术部位感染、器官/腔隙手术部位感染和/或计划外再次手术）无统计学显著差异。ACS-NSQIP-P中未记录人工耳蜗植入特有的并发症，如面神经麻痹、脑脊液漏和乳突炎。
与大龄儿童相比，婴儿术后即刻的一般外科并发症并不更多，尽管总手术时间、住院时间和再入院率的发生频率显著更高。
