Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Department of Pediatric Otolaryngology-Head and Neck Surgery, Children's Health, Dallas, Texas, USA.
Otolaryngol Head Neck Surg. 2023 Aug;169(2):258-266. doi: 10.1002/ohn.268. Epub 2023 Feb 5.
To estimate the incidence of inpatient and ambulatory pediatric tonsillectomies in the United States in 2019.
Cross-sectional analysis.
Healthcare Cost and Utilization Project databases.
We determined national incidences of hospital-based ambulatory procedures, inpatient admissions, and readmissions among pediatric tonsillectomy patients, ages 0 to 20 years, using the Kids Inpatient Database, Nationwide Ambulatory Surgery Sample, and Nationwide Readmission Database. We described the demographics, commonly associated conditions, complications, and predictors of readmission.
An estimated 559,900 ambulatory and 7100 inpatient tonsillectomies were performed in 2019. Among inpatients, the majority were male (59%) and the largest ethnic group was white (37%). Adenotonsillar hypertrophy (ATH), 79%, and obstructive sleep apnea (OSA), 74%, were the most frequent diagnosis and Medicaid (61%) was the most frequent primary payer. The majority of ambulatory tonsillectomy patients were female (52%) and white (65%); ATH, OSA, and Medicaid accounted for 62%, 29%, and 45% of cases, respectively, (all p < .001 when compared to inpatient cases). Common inpatient complications were bleeding (2%), pain/nausea/vomiting (5.6%), and postprocedural respiratory failure (1.7%). On the other hand, ambulatory complications occurred in less than 1% of patients. The readmission rate was 5.2%, with pain/nausea/vomiting and bleeding accounting for 35% and 23% of overall readmissions. All Patient Refined Diagnosis Related Groups severity of illness subclass predicted readmission (odds ratio = 2.18, 95% confidence interval = 1.73-2.73, p < .001).
A total of 567,000 pediatric ambulatory and inpatient tonsillectomies were performed in 2019; the majority were performed in ambulatory settings. The index admission severity of illness was associated with readmission risk.
估计 2019 年美国住院和门诊小儿扁桃体切除术的发病率。
横断面分析。
医疗保健成本和利用项目数据库。
我们使用 Kids Inpatient Database、全美门诊手术样本和全美再入院数据库，确定了 0 至 20 岁小儿扁桃体切除术患者的基于医院的门诊手术、住院入院和再入院的全国发病率。我们描述了人口统计学特征、常见相关疾病、并发症和再入院的预测因素。
2019 年共进行了 559900 例门诊和 7100 例住院扁桃体切除术。在住院患者中，大多数为男性（59%），最大的种族群体为白人（37%）。腺样体扁桃体肥大（ATH）占 79%，阻塞性睡眠呼吸暂停（OSA）占 74%，是最常见的诊断，医疗补助（Medicaid）占 61%，是最常见的主要支付人。大多数门诊扁桃体切除术患者为女性（52%）和白人（65%）；ATH、OSA 和 Medicaid 分别占 62%、29%和 45%的病例（与住院病例相比，所有差异均 < .001）。常见的住院并发症包括出血（2%）、疼痛/恶心/呕吐（5.6%）和术后呼吸衰竭（1.7%）。另一方面，门诊并发症发生在不到 1%的患者中。再入院率为 5.2%，疼痛/恶心/呕吐和出血占所有再入院的 35%和 23%。所有患者精细诊断相关组（All Patient Refined Diagnosis Related Groups，APR-DRG）严重程度亚类预测了再入院（比值比 = 2.18，95%置信区间 = 1.73-2.73，p < .001）。
2019 年共进行了 567000 例小儿门诊和住院扁桃体切除术；其中大多数是在门诊进行的。入院时的疾病严重程度与再入院风险相关。
