21三体综合征患儿扁桃体切除术后脓毒症风险是否更高？
Do children with trisomy 21 have a greater risk of post-tonsillectomy sepsis?
文献信息
| PMID | 42804929 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Shayna Cooperman |
| 作者单位 | Lucile Packard Children's Hospital, 801 Welch Road, Stanford, CA, 94305, USA. Electronic address: shaycoop@stanford.edu. |
| 期刊 | International journal of pediatric otorhinolaryngology |
| SCI 分区 | Q2 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
重要性： 扁桃体切除术后脓毒症是一种罕见但可能危及生命的并发症。与无21三体综合征的患儿相比，21三体综合征患儿是否风险增加尚不清楚。
目的： 比较伴或不伴21三体综合征的儿童患者扁桃体切除术后脓毒症的发生率和风险。
设计、场所和参与者： 使用包含保险索赔和电子健康记录的大型去标识化全国数据库进行的回顾性队列研究。通过手术代码识别接受扁桃体切除术的18岁以下患者。排除既往有脓毒症、免疫缺陷或近期住院的患者。将21三体综合征患者与无21三体综合征患者进行比较。
主要结局和指标： 主要结局为扁桃体切除术后15天内的脓毒症。次要结局包括术后感染。计算比值比（OR）和95%置信区间（CI）。
结果： 在148,376例接受扁桃体切除术的儿童患者中，2161例患有21三体综合征。21三体综合征患者年龄更大（平均年龄7.6岁 vs 6.2岁），且合并症负担高于对照组。两组术后感染率相似（OR，0.80；95% CI，0.57-1.16）。21三体综合征患者中有5/2161例（0.23%）发生脓毒症，对照组中有34/146,215例（0.02%）。21三体综合征与术后脓毒症风险显著增加相关（OR，9.97；95% CI，3.04-25.66）。
结论与意义： 尽管总体术后感染率相当，但21三体综合征患儿扁桃体切除术后脓毒症的比值增加。需要进一步研究以更好地描述危险因素和潜在的预防策略。
英文摘要
IMPORTANCE: Post-tonsillectomy sepsis is a rare but potentially life-threatening complication. Whether pediatric patients with Trisomy 21 are at increased risk compared with those without Trisomy 21 remains unclear.
OBJECTIVE: To compare the incidence and risk of postoperative sepsis following tonsillectomy in pediatric patients with and without Trisomy 21.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using a large de-identified national database containing insurance claims and electronic health records. Patients younger than 18 years who underwent tonsillectomy were identified using procedural codes. Patients with prior sepsis, immunodeficiency, or recent hospitalization were excluded. Patients with Trisomy 21 were compared with those without Trisomy 21.
MAIN OUTCOMES AND MEASURES: The primary outcome was sepsis within 15 days of tonsillectomy. Secondary outcomes included postoperative infection. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
RESULTS: Among 148,376 pediatric patients who underwent tonsillectomy, 2161 had Trisomy 21. Patients with Trisomy 21 were older (mean age, 7.6 vs 6.2 years) and had a greater comorbidity burden than controls. Postoperative infection rates were similar between groups (OR, 0.80; 95% CI, 0.57-1.16). Sepsis occurred in 5 of 2161 patients with Trisomy 21 (0.23%) and 34 of 146,215 controls (0.02%). Trisomy 21 was associated with significantly greater odds of postoperative sepsis (OR, 9.97; 95% CI, 3.04-25.66).
CONCLUSIONS AND RELEVANCE: Although overall postoperative infection rates were comparable, pediatric patients with Trisomy 21 had increased odds of postoperative sepsis following tonsillectomy. Further study is warranted to better characterize risk factors and potential preventive strategies.