Abstract:
:Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1% were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7%), in large (bed-size) hospitals (LH, 57.8%), and in those who were electively admitted (EA, 67.3%). Frequently present CMC in patients included obstructive sleep apnea (OSA, 26.4%), chronic pulmonary disease (CPD, 14.6%), neurological disorders (ND, 6.7%), and obesity (4.8%). Majority of patients were discharged routinely (98%). Overall complication rate was 6.4% with common complications being postoperative pneumonia (2.3%), bacterial infections (1.4%), respiratory complications (1.3%), and hemorrhage (1.2%). All-cause mortality included a total of 60 patients. Patients in TH (odds ratio [OR] = 0.72, 95%CI = 0.62-0.85), LH (OR = 0.80, 95% CI = 0.69-0.93), and those who had the procedures during EA (OR = 0.64, 95% CI = 0.56-0.74) had significantly lower odds of complications compared with their counterparts. CMC such as anemia, CPD, coagulopathy, HT, ND, and fluid/electrolyte disorders were independent predictors of significantly higher complication risk (P < .05). In conclusion, hospitalized children who underwent tonsillectomy (w/woA) in large or teaching hospitals, or during elective admissions had lower risk of complications. Comorbidity is an important independent predictor of complications in this cohort.
journal_name
Clin Pediatr (Phila)journal_title
Clinical pediatricsauthors
Allareddy V,Martinez-Schlurmann N,Rampa S,Nalliah RP,Lidsky KB,Allareddy V,Rotta ATdoi
10.1177/0009922815616885subject
Has Abstractpub_date
2016-06-01 00:00:00pages
593-602issue
7eissn
0009-9228issn
1938-2707pii
0009922815616885journal_volume
55pub_type
杂志文章abstract::Patients with cyclic vomiting syndrome suffer from recurring episodes of severe nausea and vomiting. This paper presents 6 patients who responded to 1-carnitine administration. Average time between episodes was 1.7 months before carnitine administration and increased to 1.1 years after carnitine administration. Averag...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280204100307
更新日期:2002-04-01 00:00:00
abstract::The Adult Congenital and Pediatric Cardiology (ACPC) Section of the American College of Cardiology sought to develop quality indicators/metrics for ambulatory pediatric cardiology practice. The objective of this study was to report the creation of metrics for patients with Kawasaki disease. Over a period of 5 months, ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922819896098
更新日期:2020-03-01 00:00:00
abstract::Three cases are presented which illustrate the possible difficulties in differentiating between the diagnoses of Guillain-Barre Syndrome and conversion disorder. Accepted criteria are specified for each condition, as well as some associated features often characteristic of similar cases. Supportive interdisciplinary t...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289103001002
更新日期:1991-10-01 00:00:00
abstract::A study was undertaken to evaluate the trends in radiological follow up of childhood pneumonia among consultant pediatricians throughout the United Kingdom. A questionnaire was sent to 120 consultant pediatricians. Among the 88 respondents, 18% would carry out a repeat chest radiograph on follow-up of all their patien...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922806290055
更新日期:2007-03-01 00:00:00
abstract::Obesity is a common nutritional problem among children. Using the Futrex 5000A method of bodyfat measurement, this prospective study determined the percentage bodyfat in a self-selected, indigent, predominantly black population and the accuracy of perceived body image. Bodyfat exceeded the optimal range in 39% and 67%...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289703600707
更新日期:1997-07-01 00:00:00
abstract::A 12-hour fasting lipid profile was obtained from 88 otherwise healthy obese (BMI > or = 95%) adolescents (age 16 +/- 1 years, BMI 36 +/- 1 kg/m(2), 55 males, 33 females, 57% Hispanic, 23% African American, 19% Caucasian, 1% Asian American). About 56% of the obese adolescents exhibited lipid abnormalities based on cut...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922809341076
更新日期:2010-01-01 00:00:00
abstract::A descriptive analysis was done on 73 consecutive cases of childhood sexual abuse seen in 1978. There were conspicuous similarities among the cases. Sexually abused children tended to come from households with evidence of family stress. The events occurred in safe havens such as the childrens' own homes, by individual...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288001901007
更新日期:1980-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Little is known about the magnitude of multiple chronic conditions (MCC) in children. This study describes the prevalence of and patterns of comorbidities in children receiving Medicaid assistance. METHODS:Diagnoses from 5 years of Medicaid claims data were reviewed and identified 128,044 chi...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922815574073
更新日期:2015-04-01 00:00:00
abstract::In a review of 17 adolescents and children (excluding newborns) with definite clinical signs, symptoms, and laboratory findings of hypothyroidism, 11 patients (65%) had anemia. The mean corpuscular volume (MCV) of the red blood cells was either macrocytic or normocytic. The hemoglobin did not correlate with the serum ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288102001102
更新日期:1981-11-01 00:00:00
abstract::Although pediatricians are increasingly aware of the problem of undernutrition in children with neurologic disabilities, many of these children remain poorly nourished despite prolonged attempts at oral feedings. We studied the effects of tube feeding on such children, using either nasogastric (NG) or gastrostomy (GT)...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289403300608
更新日期:1994-06-01 00:00:00
abstract::An age-appropriate questionnaire (GASP-Q) was used to assess the frequency and severity of the gastroesophageal reflux disease (GERD) symptoms: abdominal/belly pain, chest pain/heartburn, pain after eating, nausea, burping/belching, vomiting/regurgitation, choking when eating, and difficulty swallowing, in adolescents...
journal_title:Clinical pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1177/0009922806292792
更新日期:2006-10-01 00:00:00
abstract::As clinicians, pediatricians need to be cognizant of the how the principles of equity, social justice, and children's rights help to inform and guide us as we strive for the health and well being of all children. Children of the world are frequently the most vulnerable global citizens facing poverty, displacement, and...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922811417302
更新日期:2012-07-01 00:00:00
abstract::The paper presents clinical manifestations and results of cytogenetic examination of two patients with trisomy 8 mosaicism syndrome. The findings confirm the extreme phenotype variability of this syndrome. Both the first patient, a mentally retarded child with multiple dysmorphic changes, and the second, a 31-year-old...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288802701109
更新日期:1988-11-01 00:00:00
abstract::Families of children voluntarily enrolled in a managed care program for children with special health care needs receiving SSI and Medicaid benefits and their case managers were surveyed regarding care satisfaction, quality, and access. Claims data were used to compare the cost and utilization of health care before and...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289903800305
更新日期:1999-03-01 00:00:00
abstract::Objectives. The available literature on pulmonary disease in pediatric inflammatory bowel disease is limited. We evaluated the prevalence of pulmonary manifestations in pediatric inflammatory bowel disease and their association with disease severity. Methods. Patients completed the St. George's Respiratory Questionnai...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922820910821
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:The qualitative research presented here is part of a larger project on the significance of medical clowning during invasive examinations in children in the Department of Gastroenterology and the Center for the Sexually Abused in a hospital in Israel. It investigated what makes up the essence of medical clowni...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922815598143
更新日期:2016-01-01 00:00:00
abstract::Central nervous system (CNS) complications of hemolytic-uremic syndrome (HUS) commonly consist of alterations in mental status, seizures, and rarely hemiparesis. The authors report the clinical evolution of left hemiparesis and later choreo-athetoid movements in a patient who sustained a right lacunar infarction as a ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288702601106
更新日期:1987-11-01 00:00:00
abstract::Topical application of ocular drugs may cause serious adverse ocular or systemic side effects. Children are at greater risk for systemic side effects because ocular dosing is not weight-adjusted, and infants are especially vulnerable as a consequence of the inability to efficiently metabolize the drug, and/or an immat...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280404300114
更新日期:2004-01-01 00:00:00
abstract::Fever is a common complaint leading families to seek medical attention. Its routine management is the bread and butter of pediatric practice. When fever is seen as prolonged beyond the expected time course (eg, 10 days for a presumed viral respiratory tract infection or 3 weeks for mononucleosis), concern for fever of...
journal_title:Clinical pediatrics
pub_type: 杂志文章,评审
doi:10.1177/0009922809347799
更新日期:2010-03-01 00:00:00
abstract::The rectal-axillary temperature difference (R-A) was measured in the morning, at midday, and in the afternoon on 1,519 occasions in 1,149 children from birth to 5 years old. Of these, 302 children were febrile (rectal temperature > or = 38 degrees C) and 847 were afebrile. A wide range in R-A was found for each indivi...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289303200503
更新日期:1993-05-01 00:00:00
abstract::Parents are frequently cautioned by therapists, teachers, physicians, and online resources about potential negative effects of w-sitting in children (including hip dysplasia), despite lack of evidence. To examine relationships between w-sitting and hip dysplasia, a prospective cohort study was conducted of 104 patient...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922820940810
更新日期:2020-10-01 00:00:00
abstract::When evaluating a school-aged patient, particularly for such issues as attention deficit disorder, or learning disabilities, health-care providers are encouraged to appraise children's school performance. Although some clinicians seek teachers' comments, recent research suggests that teachers' appraisals have limited ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280204100909
更新日期:2002-11-01 00:00:00
abstract::Osteoporosis causes significant morbidity for boys with Duchenne muscular dystrophy. Corticosteroid therapy given to prolong mobility may increase the rate of osteoporosis and risk of fracture. This study of 33 boys with Duchenne muscular dystrophy determined retrospectively the incidence of vertebral fractures partic...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280304200408
更新日期:2003-05-01 00:00:00
abstract::A method for the detection of bacterial pathogens in sepsis and bacterial meningitis with 16S rRNA gene- based real-time fluorescent quantitative polymerase chain reaction (FQ-PCR) is developed. A total of 190 blood specimens and 5 cerebrospinal fluid specimens from neonates with suspected sepsis or bacterial meningit...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922809333972
更新日期:2009-07-01 00:00:00
abstract::Few tools are available to pediatricians for tracking and monitoring disability status in children. We describe the conceptual basis and pilot use of the Functional Independence Measure for Children (WeeFIM). Our pilot use of this instrument in children with limb deficiency, Down's syndrome, spina bifida, cerebral pal...
journal_title:Clinical pediatrics
pub_type: 杂志文章,评审
doi:10.1177/000992289403300708
更新日期:1994-07-01 00:00:00
abstract::A wide variety of types of pulmonary diseases and respiratory symptoms have been associated with gastroesophageal reflux (GER). Asthma, chronic bronchitis, bronchiectasis, and pulmonary fibrosis have all been linked to GER, but causal mechanisms have been difficult to establish. To characterize pulmonary function abno...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288602501101
更新日期:1986-11-01 00:00:00
abstract::A study of 58 consecutive Indian infants operated for congenital hypertrophic pyloric stenosis revealed an accentuated male predominance in the incidence of the disease and far less preoperative hemetemesis as compared to that in their Western counterparts. 'Pyloric tumor' was palpable in 89% of cases. Only 34.5% of t...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289002901002
更新日期:1990-10-01 00:00:00
abstract::The case of a six-year-old boy with newly diagnosed tracheoesophageal fistula of the H-type is presented. This diagnosis is usually made in the neonatal period, but since the symptoms may mimic other respiratory illnesses and radiologic diagnosis may be difficult, the condition may go undiagnosed for years. Since corr...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289002900210
更新日期:1990-02-01 00:00:00
abstract::Little is known of the characteristics of children experiencing school dysfunction who are evaluated by multidisciplinary teams. The records of 87 children seen during a calendar year were reviewed and information was gathered regarding their age, sex, and referral source. In addition, the chief concerns of the child'...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288802700406
更新日期:1988-04-01 00:00:00
abstract::The purpose of the Pediatric Overweight Quality Improvement Initiative (POWQII) was to demonstrate the feasibility and value of simple interventions for improving pediatric care and to address the additional needs of overweight and obese children. Practices were recruited from around New Mexico, with 16 pediatricians ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922813480844
更新日期:2013-07-01 00:00:00