Retropharyngeal and Parapharyngeal Abscesses in Children

Abstract

Research Article| November 01 2016 Retropharyngeal and Parapharyngeal Abscesses in Children AAP Grand Rounds (2016) 36 (5): 56. https://doi.org/10.1542/gr.36-5-56 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Retropharyngeal and Parapharyngeal Abscesses in Children. AAP Grand Rounds November 2016; 36 (5): 56. https://doi.org/10.1542/gr.36-5-56 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: abscess Source: Woods CR, Cash ED, Smith AM, et al. Retropharyngeal and parapharyngeal abscesses among children and adolescents in the United States: epidemiology and management trends, 2003–2012. J Pediatr Infect Dis. 2016; 5(3): 259– 268; doi: https://doi.org/10.1093/jpids/piv010Google Scholar Researchers from University of Louisville School of Medicine and University of Tennessee Health Science Center conducted a retrospective study to describe the epidemiology and hospital experience of US children diagnosed with parapharyngeal abscess (PPA) and retropharyngeal abscess (RPA). For the study, the researchers identified cases of RPA and PPA using ICD-9 codes in the Kids’ Inpatient Database (KID) for 2003, 2006, 2009, and 2012. KID includes data on inpatient pediatric admissions from dozens of states each year. For cases of RPA and PPA identified in KID, data on age, gender, management (surgical drainage or nonsurgical treatment), length of stay (LOS), and hospital charges were abstracted. Census data were used to generate nationally representative estimates of the incidence of RPA and PPA. Changes in incidence and rates of surgical management of both diagnoses during the 4-year study period were assessed statistically. Rates of RPA and PPA in children in different age groups were evaluated. In addition, costs and LOS for patients managed with surgical treatment or without surgery were compared. During the 4-year study period there were 2,685 hospital discharges for PPA and 6,233 for RPA among individuals ≤20 years old; more boys were affected than girls across all age groups. Both RPA and PPA were more common from December to May in each of the study years. The incidence of RPA increased from 2.98 per 100,000 in 2003 to 4.10 per 100,000 in 2012 (P < .01), while the rate for PPA crested at 1.49 per 100,000 in 2006 and then plateaued. RPA and PPA were more common in those <5 years than among older children. Overall, 58.1% of children with PPA were treated with surgical drainage versus 46.7% of those with RPA (P < .001). During the study period the rate of surgical management for children with RPA decreased significantly but was stable among those with PPA. Hospital charges were approximately twice as high for children with both RPA and PPA treated surgically than in those managed without surgery (P < .001 for both RPA and PPA); median LOS was also significantly longer for those managed surgically (4 days vs 3 days for those treated without surgery for both RPA and PPA). The authors conclude that hospitalization rates for children with RPA are twice as high as for PPA. Surgical management of both RPA and PPA was associated with higher costs and longer LOS. Dr. Brady has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. The authors of this study used a nationally representative sample to provide updated epidemiology and management trends of RPA and PPA in US children. Consistent with... You do not currently have access to this content.