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利用美国外科医师学会国家外科质量改进计划(ACS-NSQIP)国家数据库分析小儿后鼻孔闭锁修复术的短期风险因素概况

Short-Term Risk Factor Profile of Pediatric Choanal Atresia Repair Using ACS-NSQIP National Database.

作者信息

Marston Alexander P, Patel Terral, Nguyen Shaun A, White David R

机构信息

1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

2 College of Medicine, Medical University of South Carolina Medical School, Charleston, South Carolina, USA.

出版信息

Ann Otol Rhinol Laryngol. 2019 Sep;128(9):855-861. doi: 10.1177/0003489419848457. Epub 2019 May 8.

DOI:10.1177/0003489419848457
PMID:31067984
Abstract

OBJECTIVES

The goal of this study is to describe the 30-day postoperative sequelae of pediatric choanal atresia repair and identify predictive factors for adverse events.

STUDY DESIGN

The American College of Surgeons' National Surgery Quality Improvement Program-Pediatric (NSQIP-P) database was searched between January 2012 and December 2015 to identify pediatric patients status post choanal atresia repair. Postoperative outcomes included surgical site complications, readmissions, and total length of stay.

RESULTS

A total of 178 children underwent choanal atresia repair. The overall complication rate was 6.2%, while the 30-day readmission rate was 15%. Patients with CHARGE had a longer mean duration of hospitalization (26.91 days vs 8.05 days, = .013). Additionally, patients ≤10 days of age had longer duration of hospitalization (17.84 days vs 9.24 days, ≤ .001) and higher readmission rates (33.30% vs 10.1%, = .001). Among the nonsyndromic cohort, ventilator dependence was a predictor of postoperative complications (odds ratio [OR] = 16.08, < .001), higher readmission rates (OR = 5.46, = .002), and a longer hospital stay (OR = 18.69, < .001).

CONCLUSION

Analysis of the 2012-2015 NSQIP-P data set reveals that patients with a diagnosis of CHARGE and those ≤10 days of age have a longer duration of hospitalization. Increased risk of postoperative complications and longer duration of hospitalization were both influenced by chronic steroid use and ventilator dependence.

摘要

目的

本研究的目的是描述小儿后鼻孔闭锁修复术后30天的后遗症,并确定不良事件的预测因素。

研究设计

检索2012年1月至2015年12月期间美国外科医师学会国家外科质量改进计划-儿科(NSQIP-P)数据库,以确定后鼻孔闭锁修复术后的儿科患者。术后结果包括手术部位并发症、再入院情况和住院总时长。

结果

共有178名儿童接受了后鼻孔闭锁修复术。总体并发症发生率为6.2%,而30天再入院率为15%。患有CHARGE综合征的患者平均住院时间更长(26.91天对8.05天,P = 0.013)。此外,年龄≤10天的患者住院时间更长(17.84天对9.24天,P≤0.001)且再入院率更高(33.30%对10.1%,P = 0.001)。在非综合征队列中,呼吸机依赖是术后并发症的预测因素(比值比[OR]=16.08,P<0.001)、再入院率更高(OR = 5.46,P = 0.002)以及住院时间更长(OR = 18.69,P<0.001)。

结论

对2012 - 2015年NSQIP-P数据集的分析表明,诊断为CHARGE综合征的患者和年龄≤10天的患者住院时间更长。术后并发症风险增加和住院时间延长均受长期使用类固醇和呼吸机依赖的影响。

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