Predictors of prolonged stay after laryngeal surgery for benign neoplasms in children.
Int J Pediatr Otorhinolaryngol 2022;
158:111181. [PMID:
35594795 DOI:
10.1016/j.ijporl.2022.111181]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/02/2022] [Accepted: 05/07/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND
Pediatric benign laryngeal tumors can often be treated as same-day surgeries. This study identified factors associated with prolonged hospital stay in children undergoing laryngeal surgery for benign tumors.
METHODS
A retrospective analysis of records of pediatric patients who underwent laryngeal surgery with a post-op diagnosis of benign tumor was performed with the American College of Surgeons Pediatric National Surgery Quality Improvement Program (ACS-NSQIP-P) database (2014-2018). Clinical variables analyzed included comorbidities, total length of stay (LOS), readmission, and reoperation.
RESULTS
1775 patients were identified with a mean age at time of surgery of 8.95 years (95% CI 8.76-9.14). 966 (54.4%) were males and 809 (45.6%) were females. Mean LOS was 0.22 days (95% CI 0.12-0.32). Only 128 (7.3%) patients had a LOS of one day or more. Children with a variety of comorbidities, including premature birth, oxygen support, tracheostomy, developmental delay, and cardiac risk factors, had a significantly prolonged LOS (P < .001). Additionally, younger children were significantly more likely to stay overnight (β = -0.041, P < .001). Twenty-three (1.3%) patients were readmitted, 2 (0.1%) were reintubated, and 13 (0.7%) underwent reoperation for related reasons. Despite the association of premature birth, ventilator dependence, oxygen support, tracheostomy, esophageal/GI disease, developmental delay, seizure, neuromuscular disorders, congenital malformations, and steroid use with LOS, only younger age and ventilator dependence were associated with readmission.
CONCLUSION
This study suggests that laryngeal surgery for benign tumors is safe but recognizes that patients with comorbidities or young children may require a prolonged stay. Awareness of these implications may help guide management.
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