Hu Pin-Ching, Shih Liang-Chun, Chang Wen-Dien, Lai Jung-Nien, Liao Pei-Shao, Tai Chih-Jaan, Lin Chia-Der, Yip Hei-Tung, Shen Te-Chun, Tsou Yung-An
Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 404332, Taiwan.
Department of Otolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung 40002, Taiwan.
Life (Basel). 2022 Aug 5;12(8):1196. doi: 10.3390/life12081196.
The main aim of this study is to compare the incidence rate and severity of deep neck infection (DNI) in patients post-UPPP+ T (uvulopalatopharyngoplasty plus tonsillectomy) and without UPPP+ T. We utilized the data derived from the Longitudinal Health Insurance Database (LHID) of the National Health Insurance Research Database (NHIRD) in Taiwan from 1 January 2000 to 31 December 2012. Patients who had undergone combined UPPP and tonsillectomy were selected using National Health Insurance (NHI) surgical order. Patients with DNI were selected using International Classification of Diseases (ICD-9-CM) code. A logistic regression model was applied for risk analysis. There were 1574 patients in the UPPP+ T cohort, and 6,296 patients who did not undergo combined UPPP and tonsillectomy for the control group. Our analysis showed that patients with an obstructive sleep apnea syndrome (OSAS) history constitute 76.1% ( = 1198) of the UPPP+ T cohort. Compared to the control group, there was no significantly increased incidence rate of DNI after UPPP+ T within 1-60 months. Patients undergoing combined UPPP and tonsillectomy had a lower intubation rate for DNI, with an adjusted odds ratio of 0.47 (95% CI = 0.32-0.69). The combined UPPP and tonsillectomy does not increase the risk of DNI within 1-60 months. Furthermore, combined UPPP and tonsillectomy can reduce the severity for DNI by decreasing the intubation rate and length of hospitalization.
本研究的主要目的是比较接受悬雍垂腭咽成形术加扁桃体切除术(UPPP+T)的患者与未接受该手术的患者发生深部颈部感染(DNI)的发病率和严重程度。我们利用了台湾地区国民健康保险研究数据库(NHIRD)纵向健康保险数据库(LHID)中2000年1月1日至2012年12月31日的数据。接受UPPP和扁桃体切除术联合手术的患者通过国民健康保险(NHI)手术订单进行选择。患有DNI的患者通过国际疾病分类(ICD-9-CM)编码进行选择。应用逻辑回归模型进行风险分析。UPPP+T队列中有1574例患者,对照组有6296例未接受UPPP和扁桃体切除术联合手术的患者。我们的分析表明,有阻塞性睡眠呼吸暂停综合征(OSAS)病史的患者占UPPP+T队列的76.1%(=1198)。与对照组相比,UPPP+T术后1至60个月内DNI的发病率没有显著增加。接受UPPP和扁桃体切除术联合手术的患者DNI的插管率较低,调整后的优势比为0.47(95%CI=0.32-0.69)。UPPP和扁桃体切除术联合手术在1至60个月内不会增加DNI的风险。此外,UPPP和扁桃体切除术联合手术可以通过降低插管率和缩短住院时间来减轻DNI的严重程度。