National Database Outcomes of Esophageal Dilations
| Autor: | Arnold J. Stromberg, Michael B Mullen, Mark A. Fritz, Michael Andrew Witt |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Current Procedural Terminology Databases Factual medicine.medical_treatment Hemorrhage Esophageal Diseases Esophageal Hemorrhage 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Esophagus Postoperative Complications International Classification of Diseases Percutaneous endoscopic gastrostomy Sepsis medicine Humans Aged Retrospective Studies Aged 80 and over Gastrostomy Esophageal Perforation business.industry Mortality rate Anticoagulants Retrospective cohort study Middle Aged medicine.disease Dysphagia Mediastinitis Dilatation Surgery medicine.anatomical_structure Otorhinolaryngology Case-Control Studies 030211 gastroenterology & hepatology Female medicine.symptom business Deglutition Disorders |
| Zdroj: | The LaryngoscopeBIBLIOGRAPHY. 131(11) |
| ISSN: | 1531-4995 |
| Popis: | OBJECTIVES/HYPOTHESIS To better assess rates of postoperative complications and mortality following esophageal dilation, and to identify factors associated with adverse outcomes. STUDY DESIGN Observational, retrospective cohort study. METHODS We queried a national database of insurance claims for Current Procedural Terminology (CPT) codes representing esophageal dilation performed between 2011 and 2017. Patients aged 18 to 100 who were continuously enrolled with their insurance provider were included. Demographic information, additional CPT codes, concomitant diagnoses, and anticoagulant medication data were collected for all patients included. Postoperative mortality was assessed and International Classification of Diseases (ICD)9/10 codes for complications, including esophageal perforation, hemorrhage, mediastinitis, and sepsis were flagged. RESULTS We identified 202,965 encounters for esophageal dilation. Of these procedures, 193 were performed on a patient who underwent percutaneous endoscopic gastrostomy (PEG) during the study period and was analyzed separately. Another 244 dilations were excluded due to repeat entries. Of the remaining 202,528 procedures remaining, 42,310 were repeat dilations in the same patient. Data analysis was confined to each patient's initial dilation. 160,218 initial dilations remained. Of these, 62,107 were performed on male patients and 98,111 were performed on female patients. The average age was 57.7 years. There were 12 mortalities within 30 days postoperatively, representing 0.0075% of all dilations. Esophageal perforation and esophageal hemorrhage were the most common reported complications, with 139 and 110 occurrences, respectively. The overall per-dilation complication rate was 0.215%. CONCLUSIONS Evidence from a national insurance claim database suggests that esophageal dilation is a safe procedure with a low rate of serious complications and a 30-day all-cause mortality rate of less than 1 per 10,000 dilations. LEVEL OF EVIDENCE 4 Laryngoscope, 131:2436-2440, 2021. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text