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Analysis of Sociodemographics in Follow-Up Post-Tympanostomy Tube Placement
Grant E Gochman1, Veronica Drozdowski-Nuccio2, Richard D Hubbell2
1Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
Insights
Bilateral myringotomy with tympanostomy tube placement (BMT) follow-up is not affected by socioeconomic factors. However, patients undergoing concurrent tonsillectomy and adenoidectomy (T&A) showed lower follow-up rates.
Area of Science:
- Pediatric Otolaryngology
- Health Services Research
Background:
- Bilateral myringotomy with tympanostomy tube placement (BMT) is a common pediatric surgery.
- Previous studies lacked data on postoperative follow-up disparities.
- This study investigates factors influencing BMT follow-up.
Purpose of the Study:
- To identify disparities in patient follow-up after BMT.
- To assess the impact of socioeconomic and other factors on BMT follow-up rates.
Main Methods:
- Retrospective chart review of 750 pediatric patients.
- Data collected included demographics, medical, and socioeconomic information.
- Statistical analysis using Fisher's exact test and logistic regression.
Main Results:
- Concurrent tonsillectomy and adenoidectomy (T&A) was associated with significantly lower follow-up rates (OR=0.46, P=.01).
- Race, insurance type, comorbidities, indication, and distance did not significantly affect follow-up.
- Trends suggested lower follow-up for multiple BMTs and developmental delay, but not statistically significant.
Conclusions:
- Socioeconomic variables, surgical indication, and comorbidities do not significantly impact BMT follow-up.
- Concurrent T&A is a key factor associated with reduced follow-up.
- Diverse patient populations in large centers show consistent follow-up rates across various factors.
Objective:
To determine if disparities exist in patient follow-up post-bilateral myringotomy with tympanostomy tube placement.
Introduction:
Bilateral myringotomy with tympanostomy tube placement (BMT) is the most common surgery performed in children in the U.S. The current literature suggests there are no demographic differences in treatment of otitis media, however these studies have limited data on postoperative follow-up. This study aims to assess socioeconomic and other factors that affect follow-up after BMT.
Methods:
A retrospective chart review of pediatric patients seen at a tertiary medical center who underwent BMT was conducted. Demographic, medical, and socioeconomic information was collected. Fisher's exact test was used to estimate association between follow-up with all nominal responses. Logistic regression was used to estimate association between follow-up with quantitative responses.
Results:
A total of 750 patients (62.1% male) were included with 37.7% of patients identifying as non-Caucasian and 30.6% as Hispanic. The mean (SD) age at time of surgery was 5.1 (4.4) years. Patients undergoing a concurrent tonsillectomy and adenoidectomy (T&A) were less likely to follow-up than those with BMT alone. This was true even after adjusting for age and distance from medical center (OR = 0.46, 95% CI = 0.27-0.79; P = .01). Race, type of insurance, medical-comorbidities, indication for surgery, and distance from clinic did not affect rate of follow-up (P > .05). Those who underwent multiple BMTs and those with developmental delay may also be less likely to follow-up, although this finding did not meet statistical significance (P < .1).
Discussion:
Our study demonstrates socioeconomic variables, indication for surgery, and co-morbidities were not statistically significant factors in determining rates of follow-up after BMT. Interestingly, concurrent T&A was associated with lower rates of follow-up. Findings in this study suggest large medical centers with diverse patient populations see similar rates of follow-up post-BMT across a variety of variables.
Level Of Evidence:
3.
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