Hsueh Wan-Yi, Hsu Wei-Chung, Ko Jenq-Yuh, Yeh Te-Huei, Lee Chia-Hsuan, Kang Kun-Tai
Department of Otolaryngology, Hsinchu Cathay General Hospital, Hsinchu, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Biomedical Engineering, Yuanpei University of Medical Technology, Hsinchu, Taiwan.
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan; Department of Otolaryngology, College of Medicine, National Taiwan University, Taiwan.
Auris Nasus Larynx. 2019 Jun;46(3):397-406. doi: 10.1016/j.anl.2018.10.008. Epub 2018 Nov 2.
Because of the lack of population-based analyses, this study elucidated the epidemiology and 30-day postoperative complications of inpatient adult tonsillectomies in Taiwan.
Using the Taiwan National Health Insurance Research Database, we identified all inpatient adult tonsillectomies (age>20years) in Taiwan during 1997-2012 through International Codes of Diseases, 9th Revision. Trend of the inpatient tonsillectomy in adult during the study period was explored. Major complications of readmission, reoperation, and mortality within 30days after tonsillectomies were identified. Factors associated with major complications were analyzed using multivariate logistic model.
In total, 27,365 adults received inpatient tonsillectomies (mean age, 38.4±13.0years; 57.2% male). The overall incidence was 10.2 per 100,000 population per year among adults. Incidence rates increased from 1997 (8.2/100,000 adults) to 2012 (11.2/100,000 adults) (P trend<0.001). The rate of readmission for any reason, readmission for bleeding, reoperation for bleeding, and mortality were 4.9%, 2.2%, 1%, and 0.1%, respectively. Young age increased the risk of bleeding-related readmission and reoperation, whereas old age increased the risk of readmission for any reason and mortality. Male gender increased the risk of all major complications. Hypertension was associated with an increased risk of bleeding-related readmission (odds ratio [OR]=2.21; 95% confidence interval [CI] 1.68-2.92) and reoperation (OR=2.17; 95% CI 1.44-3.27). Existing catastrophic illness increased the risk of readmission (OR=4.28; 95% CI 3.60-5.08) for any reason and mortality (OR=3.24; 95% CI 1.37-7.65). Nonsteroidal anti-inflammatory drugs and steroids were associated with an increased risk of readmission or reoperation for bleeding.
Incidence rates of inpatient adult tonsillectomy increased during 1997-2012 in Taiwan. Age, gender, comorbidity, and drug administration characteristics were associated with major complications of adult tonsillectomies in this cohort.
由于缺乏基于人群的分析，本研究阐明了台湾地区成人住院扁桃体切除术的流行病学情况及术后30天并发症。
利用台湾全民健康保险研究数据库，我们通过国际疾病分类第九版，识别出1997年至2012年期间台湾所有成人住院扁桃体切除术（年龄>20岁）。探讨了研究期间成人住院扁桃体切除术的趋势。确定了扁桃体切除术后30天内再次入院、再次手术和死亡的主要并发症。使用多变量逻辑模型分析与主要并发症相关的因素。
共有27365名成年人接受了住院扁桃体切除术（平均年龄38.4±13.0岁；男性占57.2%）。成年人中总体发病率为每年每10万人10.2例。发病率从1997年的8.2/10万成年人增加到2012年的11.2/10万成年人（P趋势<0.001）。因任何原因再次入院、因出血再次入院、因出血再次手术和死亡率分别为4.9%、2.2%、1%和0.1%。年轻增加了与出血相关的再次入院和再次手术的风险，而老年增加了因任何原因再次入院和死亡的风险。男性增加了所有主要并发症的风险。高血压与出血相关再次入院（比值比[OR]=2.21；95%置信区间[CI]1.68 - 2.92）和再次手术（OR=2.17；95%CI 1.44 - 3.27）的风险增加相关。现患重大疾病增加了因任何原因再次入院（OR=4.28；95%CI 3.60 - 5.08）和死亡（OR=3.24；95%CI 1.37 - 7.65）的风险。非甾体抗炎药和类固醇与出血相关的再次入院或再次手术风险增加相关。
1997年至2012年期间台湾地区成人住院扁桃体切除术的发病率有所增加。年龄、性别、合并症和用药特征与该队列中成人扁桃体切除术的主要并发症相关。
