National Trends and Associated Factors of Endotracheal Intubation among Adult Inpatients with Peritonsillar Abscess. (2nd September 2014)

• Record Type: Journal Article
• Authors: Qureshi, Hannan A.; Tan, Bruce K.; Chandra, Rakesh K.; Kern, Robert C.; Smith, Stephanie S.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 151(2014)Supplement 1
• Page Start: P151
• Page End: P151
• Publication Date: 2014-09-02
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814541629a46
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: (1) Describe national trends in peritonsillar abscess (PTA) requiring endotracheal intubation (ETI). (2) Determine factors associated with ETI in patients with PTA. Methods: Years 2003 to 2010 of the Nationwide Inpatient Sample (Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality) were queried for PTA (ICD‐9 code: 475) and ETI (ICD‐9 code: 96.04) in adult patients (age ≥18 years old). Descriptive statistics and multivariate regression modeling were employed to identify factors associated with ETI. Results: From 2003 to 2010, 90, 941 (95% CI:86, 433‐95, 449) admissions associated with a PTA were identified, of which 1357 (1.5%) underwent ETI. These patients had a higher prevalence of concurrently coded sepsis (7.3% vs 1.2%), severe sepsis (13.0% vs 0.2%), and death (7.9% vs 0.1%) compared with patients without ETI. Intubated patients were significantly (all P <. 001) older (45 vs 34 years old), had a longer hospital stay (10.8 vs 2.4 days), and had more procedures (5.4 vs 0.9). Multivariate regression analysis displayed factors associated with intubation included age group 65 and older (odds ratio [OR] = 6.408, P <. 001), transfer from another hospital (OR = 2.917, P =. 029), alcohol abuse (OR = 6.445, P <. 001), anemia (OR = 2.957, P =. 002), and obesity (OR = 3.301, P <. 001). When controlling for age, sex, hospital characteristics, and number of procedures, general linear modeling demonstrated intubation accounted for $24, 374 ( P <. 001) in excess total charges per patient. Overall charges for admissions with ETI accounted for $123 million over the study period. Conclusions: Patients with PTA undergoing ETI have worse in‐hospital outcomes along with higher hospital charges. This study identifies characteristics of a PTA patient in whom clinicians should be wary of respiratory decompensation.