Nationwide readmissions after tonsillectomy among pediatric patients - United States
Nationwide readmissions after tonsillectomy among pediatric patients - United States
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DOI：
10.1016/j.ijporl.2018.01.026
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发表时间：
2018-04-01
影响因子：
1.5
通讯作者：
Mitchell, Ron B.
中科院分区：
文献类型：
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作者：
Johnson, Romaine F.;Chang, Andrew;Mitchell, Ron B.
目的：1）调查儿童扁桃体切除术伴或不伴腺样体切除术（T&A）后再入院的发生率和预测因素。2）确定可能预测再入院的因素。主题：和方法：2013年全国再入院数据库（NRD）用于检查儿童（年龄< 18岁）T&A 30天内的全因再入院。Logistic回归分析的人口统计学，诊断，保险状况，指数停留时间的长短，和家庭收入中位数与reincitation.Results：9079儿童接受T&A导致327（3.6%）患者需要再入院。再入院儿童的平均年龄为5.0岁，其中51%为女性。最常见的再入院诊断是脱水（47%）、出血（26%）和疼痛（16%）。平均再入院时间为7.3天。因出血、疼痛和脱水再入院的平均时间分别为6.3、4.5和4.1天。需要呼吸插管（OR = 4.0），有内科或外科并发症（OR = 3.3），或住院时间延长（OR = 1.03）的儿童更有可能再次入院。年龄，性别，付款人和社会经济地位和诊断阻塞性睡眠呼吸暂停（OSA）并没有增加的几率reincipitation.Conclusions：T&A后的儿童再入院主要是由于脱水，出血和疼痛。充分的症状控制对降低T&A后的再入院率具有最大的潜力。
Objectives: 1) Investigate incidence and predictors of readmissions after tonsillectomy with or without adenoidectomy (T&A) in children.2) Identify factors that may predict readmission.Settings: Nationwide cross-sectional survey of US hospital admissions. Subjects: and Methods: The 2013 Nationwide Readmission Database (NRD) was used to examine all-cause readmissions within 30 days of T&A in children (age < 18 years). Logistic regression was used to analyze the associations of demographics, diagnosis, insurance status, length of index stay, and median household income with readmission.Results: 9079 children undergoing T&A resulted in 327 (3.6%) patients requiring readmission. The average age of children readmitted were 5.0 years and they were 51% female. The most common readmission diagnoses were dehydration (47%), hemorrhage (26%), and pain (16%). The average time to readmission was 7.3 days. The average times to readmission for hemorrhage, pain and dehydration were 6.3, 4.5 and 4.1 days, respectively. Children who needed respiratory intubation (OR = 4.0), had a medical or surgical complication (OR = 3.3), or prolonged hospital stay (OR = 1.03) during the index admission were more likely to be readmitted. Age, gender, payer and socioeconomic status and diagnosis of obstructive sleep apnea (OSA) did not increase the odds of readmission.Conclusions: Readmissions in children after T&A were primarily due to dehydration, hemorrhage, and pain. Adequate symptom control in children has the greatest potential to reduce readmission rates following T&A.