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Richard Hwang, Ajay Shalwala, Ariana Tabing, Stephen Kim; The impact of hospital admission on systemic adverse outcomes after pediatric vitreoretinal surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3322.
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The intent of this study was to investigate the indications for hospital admission, rate of systemic complications, and rate of urgent return visits after vitreoretinal surgery in the pediatric population (6 months to 16 years).
Medical charts of 2307 patients who underwent vitreoretinal surgery from January 2002 through November 2011 at the Vanderbilt Eye Institute in Nashville, Tennessee, were reviewed. Of these, 151 charts were identified as patients between 6 months and 16 years of age undergoing outpatient vitreoretinal surgery and analyzed for baseline demographic information, indication for surgery, hospital admission, systemic complications, and urgent return visits within 30 days of surgery. Logistic regression and chi square analysis were performed to correlate hospital admission with indications for surgery and urgent return visits.
All 151 patients underwent general anesthesia. Indications for surgery were retinal detachment (39%), trauma (31%), glaucoma (16%), cataract (5%), uveitis (5%), epiretinal membrane (1%), persistent fetal vasculature (1%), and vitreous hemorrhage (1%). There were no documented systemic complications during or within 30 days of surgery. Thirty (20%) patients were admitted for one of the following surgical indications: retinal detachment (43%), glaucoma (37%), trauma (13%), retinoschisis (3%) and uveitis (3%). The mean age of admitted patients was 8.2 ± 5.0 years versus 8.8 ± 4.5 years for those not admitted (P=0.5). Surgical indication of glaucoma was significantly associated with hospital admission (P =0.001) while trauma was inversely associated (P = 0.02). There were 11 patients (7%) who had urgent return visits but there was no significant correlation (p=0.5) with patients who had been admitted (10%) and those who had not (7%) been admitted.
The most common indications for pediatric vitreoretinal surgery in this series were retinal detachment, trauma and glaucoma. Despite all surgeries being performed under general anesthesia, there were no documented systemic complications in this specific population. Surgery for glaucoma was significantly associated with hospital admission while in contrast trauma was associated with post-operative discharge. Hospital admission did not impact rates of systemic complications or urgent return visits.
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