Head and neck endocrine surgery in children - 1997 and 2000

Objectives: To characterize children undergoing parathyroid, thyroid, and thyroglossal duct cyst surgery in 1997 and 2000 using a nationally representative discharge database to determine whether rates and outcomes of these surgical treatments vary by age, sex, and health care system attributes. Data Source: The 1997 and 2000 Kids' Inpatient Da tabase, available through the Agency for Healthcare Re search and Quality. Study Selection: All patients 18 years and younger undergoing head and neck endocrine (HNE) procedures were included. Data Extraction: The sampling scheme of this data base allowed for calculation of national and regional es timates using Stata 7.0. Data Synthesis: An estimated 2077 and 1871 inpatient pediatric HNE procedures were performed nationally in 1997 and 2000, respectively. Most were per-formed at general (nonpediatric) teaching hospitals. There were an estimated 1102 thyroglossal duct cyst excisions, making this the most common HNE procedure and diagnosis. Thyroid lobectomy was the second most common HNE surgical treatment. Thyroid malignant neoplasm (usually treated by total thyroidectomy) was the second most common diagnosis. Neck dissections were performed in 32% of patients with thyroid malignant neoplasm. These HNE procedures accounted for more than $28 million in hospital charges in 1997 and nearly $38 million in 2000. Conclusions: Surgical treatment trends for pediatric HNE procedures remained stable between 1997 and 2000. Thyroglossal duct cyst excision and thyroid lobectomy are the most common procedures. There were regional differences in the rates of most HNE surgical treatments. In addition, hospital charges increased between 1997 and 2000.