Trends and Healthcare Use Following Different Cholesteatoma Surgery Types in a National Cohort, 2003-2019
In: Otol Neurotol; (2021-10-01)
Online
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Zugriff:
Objective To describe national trends in cholesteatoma management. Study design and setting Retrospective analysis Optum Clinformatics® Database from 2003 to 2019. Patients 16,179 unique adult and pediatric patients who received cholesteatoma surgery. Interventions and main outcome measures Patients were categorized into three groups by initial surgical modality: canal wall down (CWD), canal wall up (CWU), and tympanoplasty without mastoidectomy (TnoM). Three major comparisons between groups were performed: 1) temporal trends, 2) clinical and sociodemographic determinants, and 3) healthcare use in terms of total costs and incidence of postoperative imaging and subsequent surgery. Results Overall, 23.2% received initial CWD surgery, 44.3% CWU, and 32.5% TnoM. 1) The incidence of initial CWD surgery decreased (odds ratios [OR] = 0.98, 95% confidence intervals [CI] [0.97,0.99]), while CWU increased (OR = 1.02, 95% CI [1.01,1.03]), and TnoM remained stable over the study period (OR = 0.99, 95% CI [0.98,1.00]). 2) Relative to CWU, TnoM surgery was less likely in adults, patients with prior complications, and non-White patients, while being more likely in patients with higher household income. CWD was more likely than CWU in adults, patients with prior complications, and non-White patients, while income had no effect. 3) Postoperative costs for CWU and CWD were similar. In 2 years following initial surgery, postoperative imaging and/or subsequent surgery was performed in 45.48% of CWD, 57.42% of CWU, and 41.62% of TnoM patients. Conclusions Incidence of initial CWD surgery decreased and social disparities in cholesteatoma management were observed. Postoperative imaging or second-look surgery were performed in less than 60% of patients with initial CWU surgery and over 40% of patients with initial CWD.
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Trends and Healthcare Use Following Different Cholesteatoma Surgery Types in a National Cohort, 2003-2019
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Autor/in / Beteiligte Person: | Ahmad, Iram N. ; Alyono, Jennifer C. ; Cheng, Alan G. ; Chang, Kay W. ; Zhen Jason Qian ; Tran, Emma D. |
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Quelle: | Otol Neurotol; (2021-10-01) |
Veröffentlichung: | 2021 |
Medientyp: | unknown |
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