Comparing 30-Day Morbidity and Mortality in Pediatric and Adult Otologic Surgery

Abstract

Objective

To determine differences in timing and rate of postoperative adverse events among pediatric and adult populations undergoing specific otologic procedures.

Study Design

Administrative database study.

Setting

Multi-institutional database.

Subjects and Methods

The National Surgical Quality Improvement Program (NSQIP) and NSQIP-Pediatric (NSQIP-P) were used to extract data from 819 adults (years 2005-2010) and 7020 children (years 2012-2014) undergoing tympanoplasty and (tympano)mastoidectomy, respectively. Simple summary statistics, χ², and multivariable logistic regression analyses were performed.

Results

There were no significant differences in overall adverse event rates between adults (2.9%) and children (2.3%) (P = .233). Adults experienced infectious complications more frequently than did children (0.4% vs 0.0%, P = .002). Postdischarge complications accounted for 83.7% of all complications. Children treated by pediatric otolaryngologists had higher readmission rates (odds ratio [OR], 2.80; 95% confidence interval [CI], 1.20-3.60; P = .002). Tympanomastoidectomy was associated with higher odds of reoperation (OR, 1.02; 95% CI, 1.01-1.03; P < .001), as was undergoing a concurrent procedure that did not include myringotomy (OR, 3.38; 95% CI, 1.47-7.79; P = .004).

Conclusion

Both adult and pediatric otologic surgery are safe, with patients experiencing similarly low complication rates. Most adverse events occur after discharge.