Temporal Trends in and Patient Characteristics Associated with Surgery for Otitis Media.

IF 2.2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2024-12-05 DOI:10.1002/lary.31916

Kavita Dedhia, Mitchell Maltenfort, Jenna Briddell, David Horn, Carol Li, Prasanth Pattisapu, Diego Preciado, Cedric V Pritchett, Todd Wine, Christopher B Forrest

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Abstract

Objectives: To evaluate temporal trends and identify patient characteristics associated with otitis media (OM) surgery.

Methods: A retrospective cohort study performed using electronic health record data from seven large pediatric medical networks from January 1, 2009, to December 31, 2022. Children <6 months old cohort entrance time and OM history were included and followed longitudinally.

Results: The database included 1,448,390 children entering at age <6 months of which 5.3% underwent tympanostomy tube insertion (TTI). Inclusion criteria was met by 454,924 children. Age at first OM was 1.6 years (standard deviation [SD]: 1.1), with mean follow-up of 6.3 years (SD 3.7), and 249,818 (54.9%) were male. Among children with OM 64,950 (14.3%) underwent only TTI, and 13,188 (2.9%) had TTI with adenoidectomy (TTI-A). Over time, TTI only rates exhibited seasonal fluctuations with a drop in 2020, TTI-A rates were flat. The following patient characteristics greatly increased TTI: sensorineural hearing loss (adjusted hazard ratio, aHR 4.0, [95% confidence interval, CI] 3.9-4.1), chronic adenoiditis (aHR 3.4 [95% CI 3.0-3.5]), and cleft palate (aHR 1.9 [95% CI 1.8-2.0]). Children 4-8 years old (aHR >11.7 [95% CI 10.6-16.4]), history of chronic adenoiditis (aHR 6.4 [95% CI 5.4-7.7]), or sleep disorders (aHR 4.9 [95% CI 4.7-5.2]) greatly increased TTI-A odds.

Conclusions: Overall TTI rate was 5.3%, which increased to approximately 20% in children with OM. Aside from the COVID-19 pandemic, surgical rates have been stable. Though multiple characteristics increase the risk of TTI, sensorineural hearing loss for TTI only, and older age in the TTI-A subset carried the highest risk.

Level of evidence: 3 Laryngoscope, 2024.

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中耳炎手术的时间趋势和患者特征。

目的：评估中耳炎（OM）手术的时间趋势和患者特征。方法：采用2009年1月1日至2022年12月31日七个大型儿科医疗网络的电子健康记录数据进行回顾性队列研究。结果：该数据库包括1448390名在11.7岁（95% CI 10.6-16.4）时入组的儿童，慢性腺样体炎（aHR 6.4 [95% CI 5.4-7.7]）或睡眠障碍（aHR 4.9 [95% CI 4.7-5.2]）的病史大大增加了TTI-A的几率。结论：总体TTI率为5.3%，在OM患儿中增加到约20%。除了新冠肺炎大流行外，手术率一直保持稳定。虽然多种特征增加TTI的风险，但仅TTI的感觉神经性听力损失和TTI- a亚群中年龄较大的风险最高。证据级别：3喉镜，2024。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects