International journal of pediatric otorhinolaryngology · 2025
Outcomes of laryngeal surgery in children with congenital laryngomalacia and neurological and neurodevelopmental comorbidities - A NSQIP analysis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kanaris Achilles A, Szymczak Alexander J, Piwowarczyk Paulina, Ghadersohi Saied, Hazkani Inbal
Аннотация
INTRODUCTION: Children with neurological and neurodevelopmental comorbidities (NNC) may experience poorer post-operative outcomes following the surgical management of laryngomalacia. The objective of this study is to assess short-term outcomes of this group.
METHODS: A retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program - Pediatric Database years 2015-2023. Pediatric patients ages 18 and under were selected by CPT codes 31541 and 31561 and ICD-10 code Q31.5. NNC were defined as the presence of impaired cognitive status/developmental delay, seizure disorder, cerebral palsy, structural central nervous system abnormality, or neuromuscular disorder.
RESULTS: A total of 5805 cases met the inclusion criteria, with 1229 cases involving patients with NNC. Patients with NNC were older at the time of surgery (14.7 vs. 4.1 months; p < 0.001), more frequently classified as American Society of Anesthesiologists class 3 (71 % vs. 46 %, p < 0.001), more likely to have cardiac risk factors (38.7 % vs. 13.2 %; p < 0.001) and to be born prematurely (31.5 % vs. 18.4 %; p < 0.001). While controlling for sociodemographic and medical factors, children with NNC were at 2.85 times greater odds of developing post-operative pneumonia (95 % CI 1.36-6.01, p = 0.005), 2.35 times greater odds of requiring oxygen at discharge (95 % CI 1.61-3.44, p < 0.001), and 1.90 times greater odds of undergoing unplanned reintubation (95 % CI 1.04-3.45, p = 0.036).
CONCLUSION: Patients with NNC undergoing laryngeal surgery for laryngomalacia may be at a higher risk of postoperative complications, highlighting the importance of careful evaluation of surgical management and postoperative monitoring in this population.
METHODS: A retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program - Pediatric Database years 2015-2023. Pediatric patients ages 18 and under were selected by CPT codes 31541 and 31561 and ICD-10 code Q31.5. NNC were defined as the presence of impaired cognitive status/developmental delay, seizure disorder, cerebral palsy, structural central nervous system abnormality, or neuromuscular disorder.
RESULTS: A total of 5805 cases met the inclusion criteria, with 1229 cases involving patients with NNC. Patients with NNC were older at the time of surgery (14.7 vs. 4.1 months; p < 0.001), more frequently classified as American Society of Anesthesiologists class 3 (71 % vs. 46 %, p < 0.001), more likely to have cardiac risk factors (38.7 % vs. 13.2 %; p < 0.001) and to be born prematurely (31.5 % vs. 18.4 %; p < 0.001). While controlling for sociodemographic and medical factors, children with NNC were at 2.85 times greater odds of developing post-operative pneumonia (95 % CI 1.36-6.01, p = 0.005), 2.35 times greater odds of requiring oxygen at discharge (95 % CI 1.61-3.44, p < 0.001), and 1.90 times greater odds of undergoing unplanned reintubation (95 % CI 1.04-3.45, p = 0.036).
CONCLUSION: Patients with NNC undergoing laryngeal surgery for laryngomalacia may be at a higher risk of postoperative complications, highlighting the importance of careful evaluation of surgical management and postoperative monitoring in this population.