ASPO096 - Adverse Outcomes in Asthmatic Pediatric Patients Undergoing Myringotomy with Tube Placement: A National Inpatient Analysis
Sunday, May 1, 2022
11:20 AM – 12:00 PM CT
Location: Landmark B
Karandeep S. Randhawa, BS1, Avneet Randhawa, BS1, Prayag Patel, MD1, Christina H. Fang, MD2, Jean A. Eloy, MD, FACS1;
1Department of Otolarygology - Head and Neck Surgery, New Jersey Med. Sch., Newark, NJ, 2Department of Otorhinolaryngology - Head and Neck Surgery, Albert Einstein Coll. of Med., Bronx, NY.
Introduction: Myringotomy is a commonly performed pediatric procedure, often indicated for management of otitis media. Although previous studies have examined postoperative complications and outcomes following myringotomy in different populations, such as children with developmental disorders, none to our knowledge have examined its outcomes in the context of asthma, a common comorbid condition in children. This study aims to analyze the effect of asthma comorbidity on outcomes following myringotomy with tube placement in pediatric populations.
Methods: The National Inpatient Sample database 2003-2014 was used for this analysis. Selection criteria included patients under 18 years who had a primary procedure of myringotomy with tube placement. High total charges and prolonged length of stay (LOS) were indicated by values greater than the 90th percentile of the overall sample. This analysis utilized chi square, independent samples t-test, and binary logistic regression.
Results: 32,748 weighted cases were identified, including 3,380 (10.3%) asthmatic and 29,368 (89.7%) non-asthmatic patients. Univariate analysis indicated asthmatic patients had a higher incidence of postoperative pulmonary complications (3.8% vs. 2.0%, p=0.002) but had lower total hospital charges ($20,302.69 vs. $22,908.73, p=0.023) than non-asthmatic patients. Adjusted multivariate regression analysis indicated asthmatic patients were more likely than non-asthmatics to experience complications of postoperative pneumonia (OR 3.973 95% CI 1.624-9.721, p=0.003), acute respiratory failure (OR 4.113 95% CI 1.767-9.572, p=0.001), acute pulmonary edema (OR 3.547 95% CI 1.514-7.892, p=0.003), systemic inflammatory response syndrome (OR 2.4 95% CI 1.141-5.047, p=0.021), perioperative hemorrhage (OR 2.375 95% CI 1.366-4.128, p=0.002), and packed red blood cell transfusion (OR 4.074 95% CI 1.763-9.413, p=0.001). However, asthmatic patients had decreased odds of a prolonged LOS (OR 0.375 95% CI 0.158-0.892, p=0.027) compared to non-asthmatic patients.
Conclusion: Asthma is associated with poor outcomes for pediatric patients undergoing myringotomy procedures with tube placements, and asthmatics were more likely to experience postoperative complications.