The use of perioperative ketorolac in the surgical treatment of pediatric spontaneous pneumothorax
| Autor: | R. Michael Dorman, Kaveh Vali, Sarah B. Cairo, George Ventro, David H. Rothstein |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment law.invention 03 medical and health sciences 0302 clinical medicine law Recurrence medicine Odds Ratio Humans 030212 general & internal medicine Child Retrospective Studies Mechanical ventilation Postoperative Care Pain Postoperative business.industry Anti-Inflammatory Agents Non-Steroidal Pneumothorax Retrospective cohort study General Medicine Odds ratio Perioperative Length of Stay medicine.disease Intensive care unit Surgery Ketorolac Logistic Models Treatment Outcome 030220 oncology & carcinogenesis Anesthesia Pediatrics Perinatology and Child Health Video-assisted thoracoscopic surgery Multivariate Analysis Female business medicine.drug Follow-Up Studies |
| Zdroj: | Journal of pediatric surgery. 53(3) |
| ISSN: | 1531-5037 |
| Popis: | Background We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. Methods The Pediatric Health Information System database was queried for patients ages 10–16 years discharged in the years 2004–2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication. The primary variable was any ketorolac administration between post-operative day 0 and 5. Outcomes included reintervention within 1 year, readmission, post-operative length of stay (LOS), and cost. Bivariate and multivariate logistic regression analyses were performed. Results Of 1678 records that met inclusion criteria, 395 (23%) were subsequently excluded, leaving 1283 patients for analysis. Most patients had a lung resection recorded (78%) and the majority were administered ketorolac (57%); few required reintervention (20%) or readmission (18%). Mean postoperative LOS was 5.2 ± 3.8 days and mean cost was $17,649 ± $10,599. On bivariate analysis, ketorolac administration did not correlate with any measured outcome. On both bivariate and multivariate analysis, no variable was predictive of reintervention, and only lung resection correlated with readmission (adjusted odds ratio 0.63 [95% C.I. 0.45–0.90]). Conclusion Post-operative ketorolac administration was not associated with an increased likelihood of reintervention or readmission within 1 year of operative treatment of primary spontaneous pneumothorax, suggesting that it may be used safely as part of a post-operative pain control regimen. Effects on postoperative length of stay and cost, however, were not demonstrated. Level of evidence and type of study Level III treatment study. |
| Databáze: | OpenAIRE |
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