Adrenalectomies in children and adolescents in Germany – a diagnose related groups based analysis from 2009-2017

BackgroundAdrenalectomies are rare procedures especially in childhood. So far, no large cohort study on this topic has been published with data on to age distribution, operative procedures, hospital volume and operative outcome. MethodsThis is a retrospective analysis of anonymized nationwide hospit...

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Veröffentlicht in:Frontiers in endocrinology (Lausanne) 2022-07, Vol.13, p.914449-914449
Hauptverfasser: Uttinger, Konstantin L., Riedmeier, Maria, Reibetanz, Joachim, Meyer, Thomas, Germer, Christoph Thomas, Fassnacht, Martin, Wiegering, Armin, Wiegering, Verena
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Sprache:eng
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Zusammenfassung:BackgroundAdrenalectomies are rare procedures especially in childhood. So far, no large cohort study on this topic has been published with data on to age distribution, operative procedures, hospital volume and operative outcome. MethodsThis is a retrospective analysis of anonymized nationwide hospital billing data (DRG data, 2009-2017). All adrenal surgeries (defined by OPS codes) of patients between the age 0 and 21 years in Germany were included. ResultsA total of 523 patient records were identified. The mean age was 8.6 ± 7.7 years and 262 patients were female (50.1%). The majority of patients were between 0 and 5 years old (52% overall), while 11.1% were between 6 and 11 and 38.8% older than 12 years. The most common diagnoses were malignant neoplasms of the adrenal gland (56%, mostly neuroblastoma) with the majority being younger than 5 years. Benign neoplasms in the adrenal gland (D350) account for 29% of all cases with the majority of affected patients being 12 years or older. 15% were not defined regarding tumor behavior. Overall complication rate was 27% with a clear higher complication rate in resection for malignant neoplasia of the adrenal gland. Bleeding occurrence and transfusions are the main complications, followed by the necessary of relaparotomy. There was an uneven patient distribution between hospital tertiles (low volume, medium and high volume tertile). While 164 patients received surgery in 85 different "low volume" hospitals (0.2 cases per hospital per year), 205 patients received surgery in 8 different "high volume" hospitals (2.8 cases per hospital per year; p
ISSN:1664-2392
1664-2392
DOI:10.3389/fendo.2022.914449