Jeffrey Cheng1, Beiyu Liu2, Hui-Jie Lee2. 1. Pediatric Otolaryngology, Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, United States. Electronic address: jeffrey.cheng@duke.edu. 2. Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, United States.
Abstract
OBJECTIVE: Identify adverse events associated with surgical management of head and neck lymphatic malformations in children by investigating a US national database. DATA SOURCE: Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program® (ACS NSQIP® - pediatric), years 2012-2016. METHODS: Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases (ICD), 9 th revision code: 228.1 - lymphangioma, any site or ICD-10 code D18.1. RESULTS: 163 patients were identified. 67 (41.1%) were female and 96 (58.9%) were male. The median age was 4.2 years (interquartile range [IQR] 1.6-11.3 years). Sixty-five (39.9%) underwent head and neck procedures. 19 (11.7%) patients with 30-day adverse events were identified, with unplanned reoperation being the most common; in the head and neck surgery group, there were 5 (7.7%). There was no significant difference in the occurrence of adverse events between head and neck surgery and the non-head and neck surgery group (p = 0.2238). CONCLUSIONS: No individual patient clinical factors were identified to be associated with increased rates of 30-day adverse event rates for surgical management of lymphatic malformations in children. Our investigation highlights the need for quality improvement to help decrease 30-day adverse events for surgery for this group, as the rate was quite high overall (11.7%). The wound complication rate was very low, but we observed a non-negligible number of reoperations and readmissions. Improving quality of care for surgical management of lymphatic malformations in children should focus future investigations on limiting reoperations and readmissions within the first 30 days postoperatively.
OBJECTIVE: Identify adverse events associated with surgical management of head and neck lymphatic malformations in children by investigating a US national database. DATA SOURCE: Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program® (ACS NSQIP® - pediatric), years 2012-2016. METHODS: Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases (ICD), 9 th revision code: 228.1 - lymphangioma, any site or ICD-10 code D18.1. RESULTS: 163 patients were identified. 67 (41.1%) were female and 96 (58.9%) were male. The median age was 4.2 years (interquartile range [IQR] 1.6-11.3 years). Sixty-five (39.9%) underwent head and neck procedures. 19 (11.7%) patients with 30-day adverse events were identified, with unplanned reoperation being the most common; in the head and neck surgery group, there were 5 (7.7%). There was no significant difference in the occurrence of adverse events between head and neck surgery and the non-head and neck surgery group (p = 0.2238). CONCLUSIONS: No individual patient clinical factors were identified to be associated with increased rates of 30-day adverse event rates for surgical management of lymphatic malformations in children. Our investigation highlights the need for quality improvement to help decrease 30-day adverse events for surgery for this group, as the rate was quite high overall (11.7%). The wound complication rate was very low, but we observed a non-negligible number of reoperations and readmissions. Improving quality of care for surgical management of lymphatic malformations in children should focus future investigations on limiting reoperations and readmissions within the first 30 days postoperatively.
Authors: Jospeh Chiara; Greg Kinney; Jefferson Slimp; Gi Soo Lee; Sepehr Oliaei; Jonathan A Perkins Journal: Int J Pediatr Otorhinolaryngol Date: 2009-07-09 Impact factor: 1.675