Complications in Pediatric Acute Mastoiditis: HCUP KID Analysis

Area of Science:

• Otolaryngology
• Pediatric Infectious Diseases
• Health Services Research

Background:

• Acute mastoiditis in children, a complication of otitis media, carries risks of intracranial spread.
• Intracranial complications can lead to significant morbidity and mortality.

Purpose of the Study:

• To investigate the incidence and management of complications associated with pediatric acute mastoiditis.
• To analyze treatment patterns and outcomes using a national inpatient database.

Main Methods:

• Retrospective review of the 2016 Kids' Inpatient Database.
• Identification of pediatric patients (≤21 years) diagnosed with acute mastoiditis using ICD-10-CM codes.
• Analysis of patient demographics, intracranial infections, surgical procedures, length of stay, and total charges.

Main Results:

• Over 2000 children were identified with acute mastoiditis.
• Common complications included subperiosteal abscess (6.90%) and intracranial thrombophlebitis/thrombosis (5.30%).
• Children with intracranial complications had significantly longer lengths of stay and higher total charges, with bacterial meningitis and intracranial drainage procedures being major contributors.

Conclusions:

• Intracranial complications in pediatric acute mastoiditis are associated with increased surgical interventions.
• There is considerable variability in management practices for these complications.
• Persistent controversies exist regarding the optimal management of otitis media-related complications.