Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis
Abstract Objectives To determine the rate of surgical site infections (SSI) after pediatric open airway reconstruction using a nationwide database. Study Design Cross‐sectional study of the American College of Surgeons National Surgical Quality Improvement Program‐Pediatric (ACS NSQIP‐P) Database. M...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.895 |
| _version_ | 1811238287177678848 |
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| author | Romaine F. Johnson Taylor Teplitzky Erin M. Wynings Yann‐Fuu Kou Stephen R. Chorney |
| author_facet | Romaine F. Johnson Taylor Teplitzky Erin M. Wynings Yann‐Fuu Kou Stephen R. Chorney |
| author_sort | Romaine F. Johnson |
| collection | DOAJ |
| description | Abstract Objectives To determine the rate of surgical site infections (SSI) after pediatric open airway reconstruction using a nationwide database. Study Design Cross‐sectional study of the American College of Surgeons National Surgical Quality Improvement Program‐Pediatric (ACS NSQIP‐P) Database. Methods The ACS NSQIP‐P was queried for open airway surgeries between 2013 and 2019 determining postoperative SSI and wound dehiscence with a random sample of non‐airway cases serving as a control group. Results A total of 637 laryngotracheoplasties (LTP), 411 tracheal resections (TR) and 2100 control procedures were included. LTP and TR were both performed on younger children with more comorbidities than control surgeries (p < .05). Postoperative wound complications occurred more often after airway reconstructions than non‐airway cases (6.4% vs. 2.9%, p < .001). Compared to non‐airway procedures, LTP (OR: 2.42, 95% CI: 1.62–3.61) and TR (OR: 2.07, 95% CI: 1.28–3.66) developed increased SSI. Multiple logistic regression identified dirty or infected wounds (OR: 4.61, p < .001, 95% CI: 2.35–9.03) and American Society of Anesthesiologists (ASA) Class IV (OR: 3.19, p = .02, 95% CI: 1.12–8.39) as the strongest predictors of SSI after airway reconstruction. Conclusions SSI after pediatric airway reconstruction occur in 6% of cases and are increased in infected wounds and ASA Class IV surgeries. Recognizing common factors for these complications provide reliable benchmarking to design surgical quality improvement initiatives. Level of Evidence 4. |
| first_indexed | 2024-04-12T12:39:07Z |
| format | Article |
| id | doaj.art-1878ac52af9749258065fa6ff695a5ac |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-04-12T12:39:07Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-1878ac52af9749258065fa6ff695a5ac2022-12-22T03:32:49ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-10-01751618162510.1002/lio2.895Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysisRomaine F. Johnson0Taylor Teplitzky1Erin M. Wynings2Yann‐Fuu Kou3Stephen R. Chorney4Department of Otolaryngology–Head & Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head & Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head & Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head & Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head & Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USAAbstract Objectives To determine the rate of surgical site infections (SSI) after pediatric open airway reconstruction using a nationwide database. Study Design Cross‐sectional study of the American College of Surgeons National Surgical Quality Improvement Program‐Pediatric (ACS NSQIP‐P) Database. Methods The ACS NSQIP‐P was queried for open airway surgeries between 2013 and 2019 determining postoperative SSI and wound dehiscence with a random sample of non‐airway cases serving as a control group. Results A total of 637 laryngotracheoplasties (LTP), 411 tracheal resections (TR) and 2100 control procedures were included. LTP and TR were both performed on younger children with more comorbidities than control surgeries (p < .05). Postoperative wound complications occurred more often after airway reconstructions than non‐airway cases (6.4% vs. 2.9%, p < .001). Compared to non‐airway procedures, LTP (OR: 2.42, 95% CI: 1.62–3.61) and TR (OR: 2.07, 95% CI: 1.28–3.66) developed increased SSI. Multiple logistic regression identified dirty or infected wounds (OR: 4.61, p < .001, 95% CI: 2.35–9.03) and American Society of Anesthesiologists (ASA) Class IV (OR: 3.19, p = .02, 95% CI: 1.12–8.39) as the strongest predictors of SSI after airway reconstruction. Conclusions SSI after pediatric airway reconstruction occur in 6% of cases and are increased in infected wounds and ASA Class IV surgeries. Recognizing common factors for these complications provide reliable benchmarking to design surgical quality improvement initiatives. Level of Evidence 4.https://doi.org/10.1002/lio2.895pediatric airway surgerysurgical site infectionswound dehiscence |
| spellingShingle | Romaine F. Johnson Taylor Teplitzky Erin M. Wynings Yann‐Fuu Kou Stephen R. Chorney Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis Laryngoscope Investigative Otolaryngology pediatric airway surgery surgical site infections wound dehiscence |
| title | Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis |
| title_full | Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis |
| title_fullStr | Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis |
| title_full_unstemmed | Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis |
| title_short | Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis |
| title_sort | surgical site infections after pediatric open airway reconstruction a national surgical quality improvement program pediatric analysis |
| topic | pediatric airway surgery surgical site infections wound dehiscence |
| url | https://doi.org/10.1002/lio2.895 |
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