https://scholars.lib.ntu.edu.tw/handle/123456789/592654
標題: | Population-based survey of inpatient pediatric tonsillectomy and postoperative hemorrhage in Taiwan, 1997–2012 | 作者: | Hsueh, Wan-Yi WEI-CHUNG HSU JENG-YUH KO TE-HUEI YEH Lee, Chia-Hsuan Kang, Kun-Tai |
公開日期: | 2018 | 出版社: | Elsevier Ireland Ltd | 卷: | 108 | 起(迄)頁: | 55-62 | 來源出版物: | International Journal of Pediatric Otorhinolaryngology | 摘要: | Objective: Tonsil surgery in children is a common surgical procedure, and is mostly performed as an inpatient procedure in Taiwan. This study elucidates the epidemiology and postoperative hemorrhage of inpatient tonsillectomies in Taiwanese children. Methods: This study used the Taiwan National Health Insurance Research Database for analysis. From 1997 to 2012, all in-hospital children (aged <18 years) who underwent tonsillectomies were identified through the International Codes of Diseases (9th Revision). Incidence rates and trends of inpatient pediatric tonsillectomies during the study period were identified. Major complications, including readmission, reoperation, and mortality were identified. The factors associated with major complications were analyzed. Results: From 1997 to 2012, 17326 children received inpatient tonsillectomies (mean age, 8.6 ± 3.8 y; 65% boys). The overall incidence rate was 20.6 per 100,000 children. The incidence rate was highest in children who were 6–8 years of age, and boys exhibited a higher rate than girls (P < 0.001). Longitudinal data indicated that the incidence rate increased from 1997 (15.7/100,000 children) to 2012 (19.2/100,000 children) (P trend < 0.001). The proportions of readmission for any reason, readmission for bleeding, and reoperation were 1.8%, 0.9%, and 0.3%, respectively. No mortality occurred within 30 days of the tonsillectomy. A multivariable logistic model indicated that toddlers were associated with an increased risk of readmission for any reason (OR, 2.70; 95% CI 1.60–4.56), and adolescents were at risk of bleeding-related readmission (OR, 2.81; 95% CI 1.91–4.14) and reoperation (OR, 2.86; 95% CI 1.47–5.55). Children with comorbidities (OR, 3.14; 95% CI 1.93–5.09) or a surgical indication of tumor (OR, 11.73; 95% CI 4.93–27.91) had a higher risk of readmission. The use of nonsteroidal anti-inflammatory drugs or steroids is associated with an increased risk of readmission or reoperation. Moreover, concurrent procedures (i.e., adenoidectomy, ear surgery, or nasal surgery) did not increase the risk of readmission or reoperation. Conclusions: The incidence rate and indications of obstructive sleep disorders for inpatient pediatric tonsillectomy increased during 1997–2012 in Taiwan. Postoperative readmission and reoperation were rare. Age, surgical indication, comorbidities, and drug administration were associated with readmission or reoperation in this study cohort. ? 2018 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85042313571&doi=10.1016%2fj.ijporl.2018.02.021&partnerID=40&md5=6b52d1e159adf71b63d7386336b65fa2 https://scholars.lib.ntu.edu.tw/handle/123456789/592654 |
ISSN: | 0165-5876 | DOI: | 10.1016/j.ijporl.2018.02.021 | SDG/關鍵字: | nonsteroid antiinflammatory agent; steroid; adenoidectomy; age; Article; child; cohort analysis; comorbidity; ear surgery; epidemiological data; female; hospital patient; hospital readmission; human; ICD-9; incidence; longitudinal study; major clinical study; male; nose surgery; postoperative hemorrhage; priority journal; reoperation; risk factor; sex difference; sleep disordered breathing; surgical mortality; Taiwan; tonsillectomy; treatment indication; trend study; adolescent; factual database; hospital patient; infant; length of stay; palatine tonsil; postoperative hemorrhage; preschool child; questionnaire; statistics and numerical data; surgery; tonsillectomy; Adolescent; Child; Child, Preschool; Databases, Factual; Female; Humans; Incidence; Infant; Inpatients; Length of Stay; Male; Palatine Tonsil; Patient Readmission; Postoperative Hemorrhage; Reoperation; Risk Factors; Surveys and Questionnaires; Taiwan; Tonsillectomy |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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