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J Neurol Surg B Skull Base 2022; 83(01): 076-081
DOI: 10.1055/s-0040-1716676
Original Article

Effects of Preoperative Embolization on Juvenile Nasopharyngeal Angiofibroma Surgical Outcomes: A Study of the Kids' Inpatient Database

Jonathan S. Choi 
1   Department of Otolaryngology, Head & Neck Surgery, Baylor College of Medicine, Houston Texas, United States
,
Justin Yu
1   Department of Otolaryngology, Head & Neck Surgery, Baylor College of Medicine, Houston Texas, United States
,
Benjamin D. Lovin
1   Department of Otolaryngology, Head & Neck Surgery, Baylor College of Medicine, Houston Texas, United States
,
Alyssa C. Chapel
1   Department of Otolaryngology, Head & Neck Surgery, Baylor College of Medicine, Houston Texas, United States
,
Akash J. Patel
1   Department of Otolaryngology, Head & Neck Surgery, Baylor College of Medicine, Houston Texas, United States
2   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States
,
K. Kelly Gallagher
1   Department of Otolaryngology, Head & Neck Surgery, Baylor College of Medicine, Houston Texas, United States
2   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States
› Institutsangaben Funding None.
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Abstract

Objectives The aim of the study is to evaluate the effect of preoperative vascular embolization (PVE) on juvenile nasopharyngeal angiofibroma (JNA) surgical outcomes using a national pediatric hospitalization database.

Methods The health care cost and utilization project Kids' Inpatient Database was queried for all cases of operative management of JNA between the years of 1997 and 2016. Cases were stratified based on whether the patient received PVE. A multiple linear regression was used to predict the effect of PVE on hospital length of stay (LOS) and total cost while controlling for patient demographic factors and comorbidities. The odds ratio (OR) of receiving a perioperative blood transfusion was computed using a binary logistic regression for PVE patients.

Results A total of 473 patients who underwent JNA surgical resection in this time period were identified. The use of PVE has increased from 0% in 1997 to 66% of all cases by 2016. PVE was found to decrease LOS by 1 day (p = 0.036) and decrease the odds of needing a perioperative blood transfusion (OR = 0.511, p = 0.041). Patients receiving PVE were charged an additional $35,600 (p < 0.001), but recent data in 2016 indicate that hospital costs for PVE are decreasing.

Conclusion PVE of JNA is becoming increasingly prevalent. Embolization results in decreased hospital LOS and lower odds of needing blood transfusions. While embolization increases the cost of management, this trend should be re-evaluated as this procedure is becoming more widespread.

Keywords

JNA - embolization - length of stay - preoperative vascular embolization - health care cost


Publikationsverlauf

Eingereicht: 02. April 2020

Angenommen: 25. Juli 2020

Artikel online veröffentlicht:
12. Oktober 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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