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Revision adenoidectomy in children: a population-based cohort study in Taiwan
Chia-Hsuan Lee1,2,3, Wei-Hsiu Chang1,2, Jenq-Yuh Ko2
1Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, No. 127, Siyuan Rd., Xinzhuang Dist., New Taipei City, Taiwan.
Insights
Revision adenoidectomy rates in children were analyzed, revealing a 2.6% incidence. Male gender, young age, and concurrent nasal surgeries increased revision risk, highlighting factors for improved pediatric adenoidectomy outcomes.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Health Services Research
Background:
- Adenoidectomy is a common pediatric procedure, but data on revision surgery rates and associated risk factors are limited.
- Understanding these factors is crucial for optimizing surgical outcomes and resource allocation in pediatric care.
Purpose of the Study:
- To determine the population-level incidence of revision adenoidectomy in children in Taiwan.
- To identify clinical and demographic factors associated with the need for revision adenoidectomy.
Main Methods:
- Retrospective cohort study using the Taiwan National Health Insurance Research Database (2000-2007).
- Inclusion of children under 18 who underwent primary adenoidectomy, with at least 5 years of follow-up.
- Multivariable Cox proportional hazards model used to analyze factors associated with revision surgery.
Main Results:
- A total of 10,396 children were analyzed, with a 2.6% incidence of revision adenoidectomy over a mean follow-up of 8.7 years.
- The mean interval to revision surgery was 2.97 years, with the highest incidence in the second and third years post-primary surgery.
- Factors significantly associated with increased revision risk included male gender, young age, surgery at an eastern hospital, adenoid hypertrophy indication, and concurrent ventilation tube insertion or nasal surgeries.
Conclusions:
- The incidence of revision adenoidectomy in Taiwan is 2.6%, with specific patient and surgical factors influencing the need for repeat surgery.
- Male gender, younger age, concurrent nasal or ventilation tube insertion, and surgical location (eastern hospital) are identified as risk factors for revision adenoidectomy.
Abstract:
There is a lack of population-level analysis of revision adenoidectomy in children. This study reveals the revision rates and factors associated with paediatric revision adenoidectomy in Taiwan. From the Taiwan National Health Insurance Research Database, we identified all in-hospital children (age <18 years) who underwent adenoidectomy between 2000 and 2007. All children had received at least 5 years of follow-up from the index date, and the clinical records until 2012 were examined. Factors affecting the paediatric revision adenoidectomy were analysed using the multivariable Cox proportional hazards model. A total of 10,396 children were enrolled (mean age 7.3 years; 66% boys; mean follow-up period 8.7 years). Two hundred and seventy-five children underwent revision adenoidectomy, and the mean interval between primary adenoidectomy and revision surgery was 2.97 years. Only 58.5% of children underwent revision surgery at the initial hospital. The incidence of revision surgery was highest in the second year (0.69%), followed by the third year (0.53%) after primary adenoidectomy. The multivariable Cox proportional hazards model revealed that young age [hazard ratio (HR) = 0.8], male gender (HR = 1.57), surgery at an eastern hospital (HR = 2.08), surgical indication of adenoid hypertrophy (HR = 1.51), and concurrent ventilation tube insertion (HR = 2.61) or nasal surgeries (HR = 4.84) were associated with revision adenoidectomy. The incidence of revision adenoidectomy in Taiwan was 2.6%. Male gender, young age, concurrent nasal or ventilation tube insertion, and surgery at an eastern hospital increased the risk of revision.
