Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume
Objective To evaluate the management of juvenile nasopharyngeal angiofibroma (JNA) from a national perspective with outcomes comparison based on hospital volume. Study Design Ten‐year Pediatric Health Information Systems (PHIS) data analysis. Methods The PHIS database was queried for the diagnosis o...
Gespeichert in:
| Veröffentlicht in: | The Laryngoscope 2023-11, Vol.133 (11), p.3216-3220 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3220 |
|---|---|
| container_issue | 11 |
| container_start_page | 3216 |
| container_title | The Laryngoscope |
| container_volume | 133 |
| creator | Adil, Eelam A. Francisco, Sarah Morgan, Ella Kawai, Kosuke Cunningham, Michael J. |
| description | Objective
To evaluate the management of juvenile nasopharyngeal angiofibroma (JNA) from a national perspective with outcomes comparison based on hospital volume.
Study Design
Ten‐year Pediatric Health Information Systems (PHIS) data analysis.
Methods
The PHIS database was queried for the diagnosis of JNA. Data regarding demographics, surgical approach, embolization, length of stay, charges, readmission, and revision surgery was collected and analyzed. Hospitals were classified as low volume if fewer than 10 cases and high volume if greater than or equal to 10 cases during the study period. A random effects model compared outcomes based on hospital volume.
Results
A total of 287 JNA patients were identified with a mean age of 13.8 (± 2.7) years. Nine hospitals were classified as high volume, accounting for a total of 121 patients. The mean length of hospitalization, blood transfusion rate, and 30‐day readmissions did not differ significantly by hospital volume. Patients cared for at high‐volume institutions were less likely to require postoperative mechanical ventilation (8.3% vs. 25.0%; adjusted RR = 0.32; 95% CI 0.14–0.73; p |
| doi_str_mv | 10.1002/lary.30640 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2786097705</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2878241530</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3570-78dcf2cb7e4ddbc8f83adffd3b463a3f48d7c0c93e78d92cdd0b751657ffecc33</originalsourceid><addsrcrecordid>eNp9kE1LwzAYgIMobk4v_gApeBGhM22aJvU2hzplOBhO9BTSfMxK2tRmVfbvzez04MFT4M3zPvA-ABxHcBhBGF8Y3qyHCKYJ3AH9CKMoTLIM74K-_0QhxfFzDxw49wZhRBCG-6CHUpqllNI-mN-3H6oqjAoeuLP1q1dVS8VNMKqWhdVF3tiSXwazdiVsqZwfc7N2hQuuuFMyWNS2CibW1cXK7zxZ05bqEOxpbpw62r4DsLi5fhxPwuns9m48moYCYQJDQqXQsciJSqTMBdUUcam1RHmSIo50QiURUGRIeTKLhZQwJzhKMdFaCYHQAJx13rqx761yK1YWTihjeKVs61hMaAozQiD26Okf9M22jT_FU5TQOPHVoKfOO0o01rlGaVY3RemLsAiyTWm2Kc2-S3v4ZKts81LJX_QnrQeiDvj0ddf_qNh0NH_ppF-I54oy</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2878241530</pqid></control><display><type>article</type><title>Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume</title><source>Wiley Online Library - AutoHoldings Journals</source><creator>Adil, Eelam A. ; Francisco, Sarah ; Morgan, Ella ; Kawai, Kosuke ; Cunningham, Michael J.</creator><creatorcontrib>Adil, Eelam A. ; Francisco, Sarah ; Morgan, Ella ; Kawai, Kosuke ; Cunningham, Michael J.</creatorcontrib><description>Objective
To evaluate the management of juvenile nasopharyngeal angiofibroma (JNA) from a national perspective with outcomes comparison based on hospital volume.
Study Design
Ten‐year Pediatric Health Information Systems (PHIS) data analysis.
Methods
The PHIS database was queried for the diagnosis of JNA. Data regarding demographics, surgical approach, embolization, length of stay, charges, readmission, and revision surgery was collected and analyzed. Hospitals were classified as low volume if fewer than 10 cases and high volume if greater than or equal to 10 cases during the study period. A random effects model compared outcomes based on hospital volume.
Results
A total of 287 JNA patients were identified with a mean age of 13.8 (± 2.7) years. Nine hospitals were classified as high volume, accounting for a total of 121 patients. The mean length of hospitalization, blood transfusion rate, and 30‐day readmissions did not differ significantly by hospital volume. Patients cared for at high‐volume institutions were less likely to require postoperative mechanical ventilation (8.3% vs. 25.0%; adjusted RR = 0.32; 95% CI 0.14–0.73; p < 0.01) or return to the operating room for residual disease than patients admitted to low‐volume hospitals (7.4% vs. 20.5%; adjusted RR = 0.38; 95% CI 0.18–0.79; p = 0.01).
Conclusions
The management of JNA is complex from both an operative and perioperative management standpoint. Over the past decade, nearly half (42.2%) of JNA patients have been managed at nine institutions in the United States. These centers have significantly lower rates of postoperative mechanical ventilation and the need for revision surgery.
Level of Evidence
3 Laryngoscope, 133:3216–3220, 2023
Juvenile nasopharyngeal angiofibroma (JNA) are rare, locally aggressive lesions. Given their rarity, most research has been limited to small case series. In this study we use national data from the PHIS database to review the demographics of JNA in the US and found surgical revision rates and the need for post‐operative mechanical ventilation are lower at high volume institutions.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.30640</identifier><identifier>PMID: 36896888</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Cancer surgery ; hospital volume ; Hospitals ; juvenile nasopharyngeal angiofibroma ; outcomes ; Pediatrics ; Throat cancer</subject><ispartof>The Laryngoscope, 2023-11, Vol.133 (11), p.3216-3220</ispartof><rights>2023 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3570-78dcf2cb7e4ddbc8f83adffd3b463a3f48d7c0c93e78d92cdd0b751657ffecc33</citedby><cites>FETCH-LOGICAL-c3570-78dcf2cb7e4ddbc8f83adffd3b463a3f48d7c0c93e78d92cdd0b751657ffecc33</cites><orcidid>0000-0002-0908-5296 ; 0000-0001-6249-1376</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.30640$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.30640$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36896888$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adil, Eelam A.</creatorcontrib><creatorcontrib>Francisco, Sarah</creatorcontrib><creatorcontrib>Morgan, Ella</creatorcontrib><creatorcontrib>Kawai, Kosuke</creatorcontrib><creatorcontrib>Cunningham, Michael J.</creatorcontrib><title>Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objective
To evaluate the management of juvenile nasopharyngeal angiofibroma (JNA) from a national perspective with outcomes comparison based on hospital volume.
Study Design
Ten‐year Pediatric Health Information Systems (PHIS) data analysis.
Methods
The PHIS database was queried for the diagnosis of JNA. Data regarding demographics, surgical approach, embolization, length of stay, charges, readmission, and revision surgery was collected and analyzed. Hospitals were classified as low volume if fewer than 10 cases and high volume if greater than or equal to 10 cases during the study period. A random effects model compared outcomes based on hospital volume.
Results
A total of 287 JNA patients were identified with a mean age of 13.8 (± 2.7) years. Nine hospitals were classified as high volume, accounting for a total of 121 patients. The mean length of hospitalization, blood transfusion rate, and 30‐day readmissions did not differ significantly by hospital volume. Patients cared for at high‐volume institutions were less likely to require postoperative mechanical ventilation (8.3% vs. 25.0%; adjusted RR = 0.32; 95% CI 0.14–0.73; p < 0.01) or return to the operating room for residual disease than patients admitted to low‐volume hospitals (7.4% vs. 20.5%; adjusted RR = 0.38; 95% CI 0.18–0.79; p = 0.01).
Conclusions
The management of JNA is complex from both an operative and perioperative management standpoint. Over the past decade, nearly half (42.2%) of JNA patients have been managed at nine institutions in the United States. These centers have significantly lower rates of postoperative mechanical ventilation and the need for revision surgery.
Level of Evidence
3 Laryngoscope, 133:3216–3220, 2023
Juvenile nasopharyngeal angiofibroma (JNA) are rare, locally aggressive lesions. Given their rarity, most research has been limited to small case series. In this study we use national data from the PHIS database to review the demographics of JNA in the US and found surgical revision rates and the need for post‐operative mechanical ventilation are lower at high volume institutions.</description><subject>Cancer surgery</subject><subject>hospital volume</subject><subject>Hospitals</subject><subject>juvenile nasopharyngeal angiofibroma</subject><subject>outcomes</subject><subject>Pediatrics</subject><subject>Throat cancer</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LwzAYgIMobk4v_gApeBGhM22aJvU2hzplOBhO9BTSfMxK2tRmVfbvzez04MFT4M3zPvA-ABxHcBhBGF8Y3qyHCKYJ3AH9CKMoTLIM74K-_0QhxfFzDxw49wZhRBCG-6CHUpqllNI-mN-3H6oqjAoeuLP1q1dVS8VNMKqWhdVF3tiSXwazdiVsqZwfc7N2hQuuuFMyWNS2CibW1cXK7zxZ05bqEOxpbpw62r4DsLi5fhxPwuns9m48moYCYQJDQqXQsciJSqTMBdUUcam1RHmSIo50QiURUGRIeTKLhZQwJzhKMdFaCYHQAJx13rqx761yK1YWTihjeKVs61hMaAozQiD26Okf9M22jT_FU5TQOPHVoKfOO0o01rlGaVY3RemLsAiyTWm2Kc2-S3v4ZKts81LJX_QnrQeiDvj0ddf_qNh0NH_ppF-I54oy</recordid><startdate>202311</startdate><enddate>202311</enddate><creator>Adil, Eelam A.</creator><creator>Francisco, Sarah</creator><creator>Morgan, Ella</creator><creator>Kawai, Kosuke</creator><creator>Cunningham, Michael J.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0908-5296</orcidid><orcidid>https://orcid.org/0000-0001-6249-1376</orcidid></search><sort><creationdate>202311</creationdate><title>Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume</title><author>Adil, Eelam A. ; Francisco, Sarah ; Morgan, Ella ; Kawai, Kosuke ; Cunningham, Michael J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3570-78dcf2cb7e4ddbc8f83adffd3b463a3f48d7c0c93e78d92cdd0b751657ffecc33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cancer surgery</topic><topic>hospital volume</topic><topic>Hospitals</topic><topic>juvenile nasopharyngeal angiofibroma</topic><topic>outcomes</topic><topic>Pediatrics</topic><topic>Throat cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adil, Eelam A.</creatorcontrib><creatorcontrib>Francisco, Sarah</creatorcontrib><creatorcontrib>Morgan, Ella</creatorcontrib><creatorcontrib>Kawai, Kosuke</creatorcontrib><creatorcontrib>Cunningham, Michael J.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adil, Eelam A.</au><au>Francisco, Sarah</au><au>Morgan, Ella</au><au>Kawai, Kosuke</au><au>Cunningham, Michael J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2023-11</date><risdate>2023</risdate><volume>133</volume><issue>11</issue><spage>3216</spage><epage>3220</epage><pages>3216-3220</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objective
To evaluate the management of juvenile nasopharyngeal angiofibroma (JNA) from a national perspective with outcomes comparison based on hospital volume.
Study Design
Ten‐year Pediatric Health Information Systems (PHIS) data analysis.
Methods
The PHIS database was queried for the diagnosis of JNA. Data regarding demographics, surgical approach, embolization, length of stay, charges, readmission, and revision surgery was collected and analyzed. Hospitals were classified as low volume if fewer than 10 cases and high volume if greater than or equal to 10 cases during the study period. A random effects model compared outcomes based on hospital volume.
Results
A total of 287 JNA patients were identified with a mean age of 13.8 (± 2.7) years. Nine hospitals were classified as high volume, accounting for a total of 121 patients. The mean length of hospitalization, blood transfusion rate, and 30‐day readmissions did not differ significantly by hospital volume. Patients cared for at high‐volume institutions were less likely to require postoperative mechanical ventilation (8.3% vs. 25.0%; adjusted RR = 0.32; 95% CI 0.14–0.73; p < 0.01) or return to the operating room for residual disease than patients admitted to low‐volume hospitals (7.4% vs. 20.5%; adjusted RR = 0.38; 95% CI 0.18–0.79; p = 0.01).
Conclusions
The management of JNA is complex from both an operative and perioperative management standpoint. Over the past decade, nearly half (42.2%) of JNA patients have been managed at nine institutions in the United States. These centers have significantly lower rates of postoperative mechanical ventilation and the need for revision surgery.
Level of Evidence
3 Laryngoscope, 133:3216–3220, 2023
Juvenile nasopharyngeal angiofibroma (JNA) are rare, locally aggressive lesions. Given their rarity, most research has been limited to small case series. In this study we use national data from the PHIS database to review the demographics of JNA in the US and found surgical revision rates and the need for post‐operative mechanical ventilation are lower at high volume institutions.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36896888</pmid><doi>10.1002/lary.30640</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-0908-5296</orcidid><orcidid>https://orcid.org/0000-0001-6249-1376</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0023-852X |
| ispartof | The Laryngoscope, 2023-11, Vol.133 (11), p.3216-3220 |
| issn | 0023-852X 1531-4995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2786097705 |
| source | Wiley Online Library - AutoHoldings Journals |
| subjects | Cancer surgery hospital volume Hospitals juvenile nasopharyngeal angiofibroma outcomes Pediatrics Throat cancer |
| title | Juvenile Nasopharyngeal Angiofibroma: Outcomes Analysis Based Upon Hospital Volume |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T14%3A23%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Juvenile%20Nasopharyngeal%20Angiofibroma:%20Outcomes%20Analysis%20Based%20Upon%20Hospital%20Volume&rft.jtitle=The%20Laryngoscope&rft.au=Adil,%20Eelam%20A.&rft.date=2023-11&rft.volume=133&rft.issue=11&rft.spage=3216&rft.epage=3220&rft.pages=3216-3220&rft.issn=0023-852X&rft.eissn=1531-4995&rft_id=info:doi/10.1002/lary.30640&rft_dat=%3Cproquest_cross%3E2878241530%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2878241530&rft_id=info:pmid/36896888&rfr_iscdi=true |