Publication date: Available online 7 December 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Jeffrey Cheng, Beiyu Liu, Hui-Jie Lee
Abstract
Objective
Identify adverse events associated with surgical management of head and neck lymphatic malformations in children by investigating a US national database.
Data source
Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program® (ACS NSQIP® - pediatric), years 2012 – 2016.
Methods
Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases (ICD), 9th revision code: 228.1 – lymphangioma, any site or ICD-10 code D18.1.
Results
163 patients were identified. 67 (41.1%) were female and 96 (58.9%) were male. The median age was 4.2 years (interquartile range [IQR] 1.6 to 11.3 years). Sixty-five (39.9%) underwent head and neck procedures. 19 (11.7%) patients with 30-day adverse events were identified, with unplanned reoperation being the most common; in the head and neck surgery group, there were 5 (7.7%). There was no significant difference in the occurrence of adverse events between head and neck surgery and the non-head and neck surgery group (p = 0.2238).
Conclusions
No individual patient clinical factors were identified to be associated with increased rates of 30-day adverse event rates for surgical management of lymphatic malformations in children. Our investigation highlights the need for quality improvement to help decrease 30-day adverse events for surgery for this group, as the rate was quite high overall (11.7%). The wound complication rate was very low, but we observed a non-negligible number of reoperations and readmissions. Improving quality of care for surgical management of lymphatic malformations in children should focus future investigations on limiting reoperations and readmissions within the first 30 days postoperatively.
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