30-Day outcomes analysis of NSQIP-pediatric for surgical management of head and neck lymphatic malformations in children

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.

Surgical Intervention for Laryngomalacia: Age-Related Differences in Postoperative Sequelae

“…Previous studies have successfully applied ACS-NSQIP-P to assess and direct quality improvement in various pediatric otolaryngologic procedures. [20][21][22][23][24][25][26][27] Thus, the primary goal of this study is to investigate the modern perioperative sequelae of laryngeal surgery for LM. In theory, ACS-NSQIP-P allows for greater generalizability of results given both large and diverse patient samples from North America, facilitating adequate statistical power to detect differences between unique patient populations of interest.…”

Children Undergoing Laryngeal Surgery for Obstructive Sleep Apnea: NSQIP Analysis of Length of Stay, Readmissions, and Reoperations

“…This data source has been previously used to evaluate and direct quality improvement in various pediatric otolaryngology procedures. 10-12 Since the NSQIP-P is a de-identified dataset, this study has exempt status from the Institutional Board Review.…”

Early Adverse Events Following Pediatric Mandibular Advancement: Analysis of the ACS NSQIP-Pediatric Database

“…This study aims to assess patient factors associated with early adverse events following mandibular advancement utilizing the American College of Surgeons (ACS) National Surgical Quality Improvement Program Pediatric (NSQIP-Pediatric) database. This database has been used extensively to analyze 30-day surgical outcomes and is of particular use for less commonly performed surgical procedures (Shah et al, 2014; Paine et al, 2016a; Paine et al, 2016b; Jubbal et al, 2017; Roxbury et al, 2017; Cheng et al, 2019a; Cheng et al, 2019b; Marston et al, 2019; Patel et al, 2020). Our analysis focuses on the infant and neonatal population for whom advancement via MDO is most often employed in the setting of PRS with the goal of helping to guide the timing of the operation and aid in preoperative risk stratification.…”