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首页> 外文期刊>JAMA otolaryngology-- head & neck surgery >Safety of Adult Tonsillectomy A Population-Level Analysis of 5968 Patients
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Safety of Adult Tonsillectomy A Population-Level Analysis of 5968 Patients

机译：成人扁桃体切除术的安全性5968例患者的人群水平分析

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IMPORTANCE Tonsillectomy is one of the most commonly performed otolaryngology procedures. The safety of this procedure in adults is based on small case series. To our knowledge, we report the first population-level analysis of the safety of adult tonsillectomies in the United States.OBJECTIVE To characterize the mortality, complication, and reoperation rate in adult tonsillectomy.DESiGN, SETTING, and PARTICIPANTS Retrospective cohort study of 5968 adult patients who underwent tonsillectomy with records in the database of the American College of Surgeons National Surgical Quality Improvement Program (2005 to 2011).INTERVENTION Tonsillectomy.MAIN OUTCOMES AND MEASURES Outcomes of interest included mortality, complications, and reoperation in the 30-day postoperative period. Statistical analysis included x2 test, t test, and multivariate logistic regression.RESULTS The 30-day mortality rate was 0.03%, the complication rate was 1.2%, and the reoperation rate was 3.2%. Most patients had a primary diagnosis of chronic tonsillitis and/or adenoiditis (82.9%), and the most common complications were pneumonia (27% of all complications), urinary tract infection (27%), and superficial site infections (16%). Patients who underwent reoperation were more likely to be male (54.0% vs 32.4%; P < .001), white (84.8% vs 75.3%; P = .02), or inpatients (24.3% vs 14.3%; P < .001) and to have postoperative complications (5.3% vs 1.1%; P < .001) than those who did not return to the operating room. On multivariate analysis, male sex (odds ratio [OR], 2.30 [95% Cl, 1.67-3.15]), inpatient status (OR, 1.52 [95% Cl, 1.04-2.22]), and the presence of a postoperative complication (OR, 4.58 [95% Cl, 2.11-9.93]) were independent risk factors for reoperation.CONCLUSIONS AND RELEVANCE In the United States, adult tonsillectomy is a safe procedure with low rates of mortality and morbidity. The most common posttonsillectomy complications were infectious in etiology, and complications were independently associated with the need for reoperation.
机译：重要信息扁桃体切除术是最常用的耳鼻喉科手术之一。此程序在成人中的安全性基于小病例系列。据我们所知，我们报告了美国成人扁桃体切除术安全性的首次人群水平分析。目的旨在表征成人扁桃体切除术的死亡率，并发症和再次手术率。设计，地点和参与者对5968名成人进行回顾性队列研究进行扁桃体切除术的患者在美国外科医师学会国家外科手术质量改善计划（2005年至2011年）的数据库中有记录。干预性扁桃体切除术主要结果和措施感兴趣的结果包括术后30天的死亡率，并发症和再次手术。 。结果：30天死亡率为0.03％，并发症发生率为1.2％，再次手术发生率为3.2％，进行了x2检验，t检验和多元logistic回归分析。大多数患者对慢性扁桃体炎和/或腺样体炎有初步诊断（82.9％），最常见的并发症是肺炎（占所有并发症的27％），尿路感染（27％）和浅表部位感染（16％）。再次手术的患者更可能是男性（54.0％vs 32.4％; P <.001），白人（84.8％vs 75.3％; P = .02）或住院患者（24.3％vs 14.3％; P <.001 ），并且比没有回到手术室的患者有术后并发症（5.3％vs 1.1％; P <.001）。在多因素分析中，男性（比值比[OR]为2.30 [95％Cl，1.67-3.15]），住院状态（OR为1.52 [95％Cl，1.04-2.22]）以及术后并发症的发生率（ OR，4.58 [95％Cl，2.11-9.93]是再次手术的独立危险因素。结论和相关性在美国，成人扁桃体切除术是一种安全的方法，死亡率和发病率均较低。扁桃体切除术后最常见的并发症是病因感染，并且并发症与再次手术的需要独立相关。

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