Patel Vijay A, Ramadan Jad, Roberts Christopher A, Carr Michele M
Department of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
West Virginia University Rockefeller Neuroscience Institute, Morgantown, WV, USA.
Int J Pediatr Otorhinolaryngol. 2020 Apr;131:109889. doi: 10.1016/j.ijporl.2020.109889. Epub 2020 Jan 17.
Identify risk factors and determine perioperative sequelae of children undergoing lateral cervical abscess incision and drainage.
Pediatric patients who underwent lateral cervical abscess incision and drainage aged 1-18 years were retrospectively queried via ACS-NSQIP-P (2012-2016) utilizing CPT code 21501. Analyzed outcomes include age, time to surgery, operative time, total length of stay, readmission, and reoperation.
A total of 1917 children were identified, with a mean age at time of surgery of 4.05 years (95% CI 3.86-4.25). The mean number of days from hospital admission to operative intervention was 1.24 days (95% CI 1.16-1.31), with a mean total length of stay of 3.64 days (95% CI 3.46-3.82). The mean number of days from hospital admission to surgery was significantly lengthened in younger children (P = .0001) and pediatric patients of non-Caucasian origin (P < 0.001). Children with positive septic parameters not only had a prolonged time to surgery but also a significantly prolonged total length of stay (P < 0.001). Finally, a persistent requirement for postoperative mechanical ventilation and prolonged operative time (P = 0.003) was found to be related to reoperation.
Younger children are more likely to have delays from hospital admission to definitive surgical intervention, but this does not appear to affect total length of stay. Recognition of pertinent clinical factors may assist in optimizing perioperative risk assessment and promote timely procedural planning in the pediatric subpopulation.
确定接受颈外侧脓肿切开引流术儿童的危险因素，并确定围手术期后遗症。
利用CPT编码21501，通过ACS-NSQIP-P（2012 - 2016）对1 - 18岁接受颈外侧脓肿切开引流术的儿科患者进行回顾性查询。分析的结果包括年龄、手术时间、手术时长、住院总时长、再入院和再次手术情况。
共识别出1917名儿童，手术时的平均年龄为4.05岁（95%可信区间3.86 - 4.25）。从入院到手术干预的平均天数为1.24天（95%可信区间1.16 - 1.31），住院总时长平均为3.64天（95%可信区间3.46 - 3.82）。年龄较小的儿童（P = 0.0001）和非白种人儿科患者（P < 0.001）从入院到手术的平均天数显著延长。脓毒症参数呈阳性的儿童不仅手术时间延长，住院总时长也显著延长（P < 0.001）。最后，发现术后持续需要机械通气和手术时间延长（P = 0.003）与再次手术有关。
年龄较小的儿童从入院到确定性手术干预的延迟可能性更大，但这似乎并不影响住院总时长。识别相关临床因素可能有助于优化围手术期风险评估，并促进儿科亚人群的及时手术规划。
