Anwaegbu Ogechukwu S, Clark Delaney E S, Iyamah Samsudeen O, Ezenwukwa Chikobi, Etufugh Ugonne L, McKinnon Brian J
John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX 77554, USA.
John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX 77554, USA.
Am J Otolaryngol. 2025 Sep-Oct;46(5):104712. doi: 10.1016/j.amjoto.2025.104712. Epub 2025 Jul 22.
Assess the rates of post-operative complications following tonsillectomy with/without adenoidectomy over a 10-year span, comparing young children and adolescents, while examining the influence of comorbidities, social determinants of health, and potential racial, and gender differences.
A retrospective cohort study using TriNetX database with de-identified electronic medical records from 57 healthcare organizations for ages 0-17 who had tonsillectomy with/without adenoidectomy from January 2014 to December 2023. Risk analysis and incidence proportion over a 10-year period for 5 outcomes occurring within 30 days, stratified by gender, race, and ethnicity. Then further subdivided into two groups: Early Childhood (0-9 years) and Adolescence (10-17 years). Statistical analysis included risk ratios (RR), and 95 confidence intervals (CI), with statistical significance set at p ≤ 0.05.
Before propensity score matching, 197,885 pediatric patients were identified. Most common complications occurring within 30 days were pain (3.1 %), post-operative hemorrhage (2.3 %) with 1.3 % requiring re-operation for control, dehydration (2.1 %), infection (0.26 %), and acute respiratory complications (0.21 %). Before propensity score matching, Early Childhood cohort (0-9 years: n = 71,024) and Adolescence cohort (10-17 years: n = 126,861). After propensity matching, n = 56,036 for both groups. Early Childhood cohort had higher rates for potential health hazards related to socioeconomic and psychosocial circumstances (p = 0.013) and environmental tobacco smoke exposure-related risks (p = 0.016) than Adolescence cohort. No significant differences in complication risks were observed between the two pediatric age groups.
Rates of dehydration and acute respiratory distress have declined, while post-operative hemorrhage, and pain have been increasing, and observable racial differences continue to persist within these complications.
III.
评估10年间行扁桃体切除术（伴或不伴腺样体切除术）后的术后并发症发生率，比较幼儿和青少年，同时研究合并症、健康的社会决定因素以及潜在的种族和性别差异的影响。
一项回顾性队列研究，使用TriNetX数据库，该数据库包含来自57个医疗机构的去识别化电子病历，涉及2014年1月至2023年12月期间年龄在0至17岁且行扁桃体切除术（伴或不伴腺样体切除术）的患者。对30天内发生的5种结局进行10年期间的风险分析和发病率比例计算，按性别、种族和民族分层。然后进一步分为两组：幼儿期（0至9岁）和青少年期（10至17岁）。统计分析包括风险比（RR）和95%置信区间（CI），设定统计学显著性为p≤0.05。
在倾向得分匹配前，共识别出197,885名儿科患者。30天内最常见的并发症为疼痛（3.1%）、术后出血（2.3%），其中1.3%需要再次手术以控制出血、脱水（2.1%）、感染（0.26%）和急性呼吸并发症（0.21%）。在倾向得分匹配前，幼儿队列（0至9岁：n = 71,024）和青少年队列（10至17岁：n = 126,861）。倾向得分匹配后，两组均为n = 56,036。幼儿队列与社会经济和心理社会状况相关的潜在健康危害发生率（p = 0.013）以及与环境烟草烟雾暴露相关的风险发生率（p = 0.016）高于青少年队列。两个儿科年龄组之间未观察到并发症风险的显著差异。
脱水和急性呼吸窘迫的发生率有所下降，而术后出血和疼痛呈上升趋势，并且在这些并发症中可观察到的种族差异仍然存在。
III级
