Resection of pediatric lung malformations: National trends in resource utilization & outcomes

Amy E. Wagenaar, Jun Tashiro, Shevonne S. Satahoo, Juan E Sola, Holly Neville, Anthony Richard Hogan, Eduardo Perez

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Purpose We sought to determine factors influencing survival and resource utilization in patients undergoing surgical resection of congenital lung malformations (CLM). Additionally, we used propensity score-matched analysis (PSMA) to compare these outcomes for thoracoscopic versus open surgical approaches. Methods Kids’ Inpatient Database (1997–2009) was used to identify congenital pulmonary airway malformation (CPAM) and pulmonary sequestration (PS) patients undergoing resection. Open and thoracoscopic CPAM resections were compared using PSMA. Results 1547 cases comprised the cohort. In-hospital survival was 97%. Mortality was higher in small vs. large hospitals, p < 0.005. Survival, pneumothorax (PTX), and thoracoscopic procedure rates were higher, while transfusion rates and length of stay (LOS) were lower, in children ≥ 3 vs. < 3 months (p < 0.001). Multivariate analysis demonstrated longer LOS for older patients and Medicaid patients (all p < 0.005). Total charges (TC) were higher for Western U.S., older children, and Medicaid patients (p < 0.02). PSMA for thoracoscopy vs. thoracotomy in CPAM patients showed no difference in outcomes. Conclusion CLM resections have high associated survival. Children < 3 months of age had higher rates of thoracotomy, transfusion, and mortality. Socioeconomic status, age, and region were independent indicators for resource utilization. Extent of resection was an independent prognostic indicator for in-hospital survival. On PSMA, thoracoscopic resection does not affect outcomes.

Original languageEnglish (US)
Pages (from-to)1414-1420
Number of pages7
JournalJournal of Pediatric Surgery
Volume51
Issue number9
DOIs
StatePublished - Sep 1 2016

Keywords

  • Bronchopulmonary sequestration
  • Congenital pulmonary airway malformation
  • Health resources
  • Outcome assessment
  • Thoracoscopy
  • Thoracotomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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