Readmissions following ambulatory pediatric endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Health Services Research

Background:

• Endoscopic sinus surgery (ESS) is an option for pediatric patients with persistent sinus disease.
• Ambulatory ESS aims to reduce healthcare costs and improve patient recovery.
• Understanding readmission rates and risk factors is crucial for optimizing pediatric surgical care.

Purpose of the Study:

• To analyze indications and readmission rates for pediatric ambulatory ESS.
• To identify patient subgroups at higher risk for readmission.
• To inform decisions regarding inpatient admission for specific pediatric populations undergoing ESS.

Main Methods:

• Retrospective review of the Pediatric Health Information Systems (PHIS) database (2004-2016).
• Analysis of pediatric patients (<18 years) undergoing ambulatory ESS between 2011-2016 with 30-day readmissions.
• Multivariable mixed-effects logistic regression to identify risk factors for readmission.

Main Results:

• The overall readmission rate for pediatric ambulatory ESS was 3.5% (128/3,669 cases).
• Common readmission indications included epistaxis, nausea/abdominal pain, respiratory infection, and sinusitis.
• Risk factors for readmission were younger age (<3 years), asthma, and cystic fibrosis.

Conclusions:

• Ambulatory ESS is generally safe for pediatric patients, with a low overall readmission rate.
• Younger children and those with asthma or cystic fibrosis have significantly higher readmission risks.
• Preoperative assessment should consider these risk factors to guide perioperative management and admission decisions.