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Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
Predictors of Surgical Site Infection in Pediatric Cochlear Implantation
Alexandra E Quimby1, Elysia Grose2, Deepti Reddy3
1Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Insights
Longer operative times and younger age increase the risk of surgical site infections (SSI) in pediatric cochlear implantation (CI). These factors are key for preventing SSIs in young CI patients.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Infectious Disease Epidemiology
Background:
- Surgical site infections (SSI) are a significant concern following cochlear implantation (CI) in pediatric patients.
- Identifying risk factors is crucial for developing targeted prevention strategies.
Purpose of the Study:
- To determine risk factors for SSI after pediatric CI.
- To analyze the association between patient and surgical variables and SSI development.
Main Methods:
- A case-control study utilizing the ACS-NSQIP Pediatric database (2012-2017).
- Analysis included 5146 pediatric CI cases, with 79 experiencing SSI.
- Uni- and multivariable logistic regression identified odds ratios (ORs) for SSI.
Main Results:
- Longer operative time was significantly associated with increased SSI risk (OR, 1.965).
- Younger patient age was also a significant risk factor, with odds decreasing with age (OR, 0.887 per 6-month increase).
- Factors like BMI, steroid use, ASA class, and hospital stay did not significantly impact SSI risk.
Conclusions:
- Longer operative time and younger age are significant risk factors for SSI in pediatric CI.
- Findings highlight the importance of optimizing operative duration and considering age in risk assessment.
- Further research should explore reducing operative time to mitigate SSI risk in pediatric CI.
Objective:
To determine risk factors for surgical site infection (SSI) after cochlear implantation (CI) in pediatric patients.
Study Design:
Case-control study.
Setting:
A total of 150 hospitals contributing data to the ACS-NSQIP Pediatric database (American College of Surgeons National Surgical Quality Improvement Program) in North America and worldwide.
Methods:
Pediatric patients (aged <18 years) undergoing CI during the years 2012 to 2017 were identified in the ACS-NSQIP Pediatric database. Uni- and multivariable logistic regression analyses were used to determine the odds ratios (ORs) of SSI (including superficial incisional, deep incisional, organ/space) occurring up to 30 days postoperatively.
Results:
A total of 79 SSIs occurred over a 5-year period (n = 5146). Longer operative time significantly increased the odds of SSI (OR, 1.965; 95% CI, 1.205-3.289). Younger age was also found to raise the odds of SSI, with decreased odds associated with each 6-month increase in age (OR, 0.887; 95% CI, 0.814-0.958).
Conclusion:
Longer operative time and younger age appear to significantly increase the odds of SSI in pediatric CI. Body mass index, recent steroid use, American Society of Anesthesiologists class, bilateral vs unilateral implantation, and hospital length of stay do not appear to significantly influence SSI risk. These findings must be interpreted in the context of the limitations inherent to adverse events reporting, which are mitigated by the stringent manner of data collection by the ACS-NSQIP, and those inherent to the definition of SSI. Future prospective studies should investigate the impact of reducing operative time on the risk of SSI and other complications in pediatric CI.
