Pediatric adenoidectomy: A population-based regional study on epidemiology and outcome

作者：Thomas Konstanze; Boeger Daniel; Buentzel Jens; Esser Dirk; Hoffmann Kerstin; Jecker Peter; Mueller Andreas; Radtke Gerald; Geissler Katharina; Finkensieper Mira; Guntinas Lichius Orlando^*

来源：International Journal of Pediatric Otorhinolaryngology, 2013, 77(10): 1716-1720.

DOI：10.1016/j.ijporl.2013.07.032

• Adenoids
• Otitis media with effusion
• Outcome
• Complication
• Epidemiology
• Health services research

Objectives: To evaluate population-based data on incidence of pediatric adenoidectomy and rate of revision surgery. %26lt;br%26gt;Methods: A retrospective study of all adenoidectomies in children was performed in the year 2009 in all otolaryngology departments in one federal state, Thuringia, in Germany. Patients%26apos; characteristics, preoperative diagnostics and postoperative complications were analyzed. The association between baseline characteristics and the risk of re-adenoidectomy was examined using Kaplan-Meier method with univariate log-rank test, and with a multivariate Cox regression model. Population data were used to calculate age-related annual rates of adenoidectomies. %26lt;br%26gt;Results: 1939 adenoidectomies were performed in 2009 in Thuringia. 89% were primary cases and 11% of the children already had an adenoidectomy prior to 2009. Immediate re-surgery because of primary hemorrhage was necessary in 0.8% of the cases. Re-adenoidectomy because of recurrent symptoms was needed in 9% of patients after a median interval of 16 months. The univariate analysis showed that the factors age %26lt;3 years and primary surgery were significantly associated to a higher risk of surgery because of recurrent symptoms The multivariate analysis showed that primary surgery was independently associated with the risk of re-surgery (hazard ratio 1.66; 95% confidence interval 1.01-2.74). The annual adenoidectomy rate was 678/100,000 underage habitants. The incidence was highest between 2 and 4 years of age. %26lt;br%26gt;Conclusions: This population based analysis is showing that adenoidectomy is performed country-wide with good results and low risk on important scale in daily routine by otorhinolaryngologists. The risk of re-adenoidectomy seems to be higher than hitherto reported by hospital-based studies.

• 出版日期2013-10