Short-Term Risk Factor Profile of Pediatric Choanal Atresia Repair Using ACS-NSQIP National Database

Area of Science:

• Pediatric Surgery
• Otolaryngology
• Healthcare Quality Improvement

Background:

• Choanal atresia is a congenital nasal obstruction requiring surgical repair in infants.
• Understanding postoperative outcomes and risk factors is crucial for optimizing patient care.

Purpose of the Study:

• To describe 30-day postoperative sequelae following pediatric choanal atresia repair.
• To identify factors predicting adverse events and prolonged hospitalization.

Main Methods:

• Retrospective analysis of the American College of Surgeons' National Surgery Quality Improvement Program-Pediatric (NSQIP-P) database (2012-2015).
• Inclusion of pediatric patients undergoing choanal atresia repair.
• Evaluation of outcomes including surgical site complications, readmissions, and length of stay.

Main Results:

• 178 pediatric patients underwent choanal atresia repair with a 6.2% complication rate and 15% 30-day readmission rate.
• Patients with CHARGE syndrome and infants ≤10 days old had significantly longer hospitalizations.
• Ventilator dependence was a strong predictor of complications, readmissions, and extended hospital stay in the nonsyndromic cohort.

Conclusions:

• CHARGE syndrome diagnosis and early infant age (≤10 days) are associated with prolonged hospitalization after choanal atresia repair.
• Ventilator dependence and chronic steroid use increase the risk of postoperative complications and longer hospital stays.