Jeffrey Cheng1, Reginald Lerebours2, Hui-Jie Lee2. 1. Pediatric Otolaryngology, Department of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA. Electronic address: jeffrey.cheng@duke.edu. 2. Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA.
Abstract
OBJECTIVE: Identify current trends, adverse events, and clinical predictors in children treated with thyroglossal duct cyst surgery. METHODS: Cross-sectional analysis using American College of Surgeons (ACS) National Surgical Quality Improvement Program® (ACS NSQIP® - pediatric), years 2012-2016. Patients were identified using CPT codes: 60280 - excision of thyroglossal duct cyst or sinus and 60281 - excision of thyroglossal duct cyst or sinus, recurrent. RESULTS: 1532 (333 inpatient and 1199 outpatient) total cases were identified. Median age was 5.16 years interquartile range [IQR] (2.87, 8.35 years). No mortalities, cases of sepsis or nerve injury were identified. Adverse event rate was 4.4% (68/1532). Inpatient cases were associated with higher rates of adverse events (p = 0.006). Adverse events mostly consistent of wound infections, unplanned reoperations and readmissions, 2.6%, 2.2% and 2.0%, respectively. The most common unplanned reoperation was hematoma, seroma, or fluid drainage (0.59%). Median length of stay was 1 day, IQR (0, 1). An adjusted, multivariable logistic regression model revealed that the odds of adverse event rates for inpatient status were 101% higher than outpatients (odd ratio [OR] = 2.01; 95% CI = 1.20, 3.37; p = 0.008). CONCLUSIONS: The most common adverse events were unplanned reoperations and readmissions. Outpatient surgery was most common and surgery for recurrent thyroglossal duct cysts was rare. Children selected for outpatient thyroglossal duct cyst surgery tended to be healthier and less medically complicated and may contribute to our observation of lower rates of adverse events compared to inpatients.
OBJECTIVE: Identify current trends, adverse events, and clinical predictors in children treated with thyroglossal duct cyst surgery. METHODS: Cross-sectional analysis using American College of Surgeons (ACS) National Surgical Quality Improvement Program® (ACS NSQIP® - pediatric), years 2012-2016. Patients were identified using CPT codes: 60280 - excision of thyroglossal duct cyst or sinus and 60281 - excision of thyroglossal duct cyst or sinus, recurrent. RESULTS: 1532 (333 inpatient and 1199 outpatient) total cases were identified. Median age was 5.16 years interquartile range [IQR] (2.87, 8.35 years). No mortalities, cases of sepsis or nerve injury were identified. Adverse event rate was 4.4% (68/1532). Inpatient cases were associated with higher rates of adverse events (p = 0.006). Adverse events mostly consistent of wound infections, unplanned reoperations and readmissions, 2.6%, 2.2% and 2.0%, respectively. The most common unplanned reoperation was hematoma, seroma, or fluid drainage (0.59%). Median length of stay was 1 day, IQR (0, 1). An adjusted, multivariable logistic regression model revealed that the odds of adverse event rates for inpatient status were 101% higher than outpatients (odd ratio [OR] = 2.01; 95% CI = 1.20, 3.37; p = 0.008). CONCLUSIONS: The most common adverse events were unplanned reoperations and readmissions. Outpatient surgery was most common and surgery for recurrent thyroglossal duct cysts was rare. Children selected for outpatient thyroglossal duct cyst surgery tended to be healthier and less medically complicated and may contribute to our observation of lower rates of adverse events compared to inpatients.
Authors: Ana Coelho; Catarina Sousa; Ana Sofia Marinho; Joana Barbosa-Sequeira; João Ribeiro-Castro; Fátima Carvalho; João Moreira-Pinto Journal: Int J Pediatr Otorhinolaryngol Date: 2017-03-06 Impact factor: 1.675
Authors: D R Farquhar; R B Rawal; M M Masood; W G McClain; L A Kilpatrick; A S Rose; C J Zdanski Journal: Clin Otolaryngol Date: 2018-07-02 Impact factor: 2.597