The National Landscape of Acute Mastoiditis: Analysis of the Nationwide Readmissions Database
| Autor: | Zachary G. Schwam, Vivian Z. Kaul, Daniel Bu, Maura K. Cosetti, Daniel-Georges Faddoul, Rocco Ferrandino, George B. Wanna, Aisosa Omorogbe |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Databases Factual medicine.medical_treatment Psychological intervention MEDLINE Mastoidectomy Mastoiditis computer.software_genre Patient Readmission Myringotomy 03 medical and health sciences 0302 clinical medicine Risk Factors Humans Medicine Risk factor Child 030223 otorhinolaryngology Retrospective Studies Database business.industry Retrospective cohort study Length of Stay Sensory Systems Hospitalization Otorhinolaryngology Child Preschool Cohort Neurology (clinical) Complication business computer 030217 neurology & neurosurgery |
| Zdroj: | Otology & Neurotology. 41:1084-1093 |
| ISSN: | 1537-4505 1531-7129 |
| DOI: | 10.1097/mao.0000000000002745 |
| Popis: | Objective To determine risk factors for readmission, prolonged length of stay, and discharge to a rehabilitation facility in patients with acute mastoiditis. Trends in treatment and complication rates were also examined. Study design Retrospective cohort study. Setting Nationwide Readmissions Database (2013, 2014). Patients Pediatric and adult patients in the Nationwide Readmissions Database with a primary diagnosis of acute mastoiditis. Interventions Medical treatment, surgical intervention. Outcome measures Rates of and risk factors for readmission, prolonged length of stay, and discharge to a rehabilitation facility. Procedure and complication rates were also examined. Results Four thousand two hundred ninety-five pediatric and adult admissions for acute mastoiditis were analyzed. The overall rates of readmission, prolonged length of stay, and discharge to a rehabilitation facility were 17.0, 10.4, and 10.2%, respectively. Children 4 to 17 years of age had the highest rates of intracranial complications, and children ≤3 years were most likely to undergo operative intervention. Any procedure was performed in 31.2% of cases, and undergoing myringotomy or mastoidectomy was associated with lower rates of readmission but higher rates of prolonged length of stay. Those with intracranial complications and subperiosteal abscesses had the highest surgical intervention rates. Conclusions Readmission, prolonged length of stay, and discharge to a rehabilitation facility are common in patients with acute mastoiditis with various sociodemographic and disease-related risk factors. While once a primarily surgical disease, a minority of patients in our cohort underwent procedures. Undergoing a surgical procedure was protective against readmission but a risk factor for prolonged length of stay. |
| Databáze: | OpenAIRE |
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