{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:05:23Z","timestamp":1768442723304,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate outcomes of surgically treated acute mastoiditis (AM) in pediatric patients using the Pediatric Health Information System (PHIS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Pediatric tertiary care centers participating in the PHIS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children aged 0 to 18 years with AM treated from January 1, 2016, to December 31, 2022, were identified using International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD\u201010) codes and categorized by surgical treatment: mastoidectomy alone, myringotomy with mastoidectomy (MMT), or myringotomy alone. Primary outcomes were length of stay (LOS)\u00a0and 90\u2010day all\u2010cause readmission. Complicated AM was defined via diagnosis codes indicating disease extension beyond the middle ear\/mastoid. Multivariable regression models adjusting for patient and hospital\u2010level variables assessed associations. Cohort validation was performed through chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1368 patients, 637 (46.6%) underwent myringotomy alone, 153 (11.2%) mastoidectomy alone, and 578 (42.3%) MMT. Complicated AM was present in 62.3%, most frequently in patients receiving mastoidectomy alone (76.5%) or MMT (77.9%). Median LOS was longer in the mastoidectomy group (5 days) compared to MMT (4 days) and myringotomy alone (3 days;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). In adjusted models, mastoidectomy (incident rate ratio [IRR]: 1.20, 95% CI: 1.07\u20101.34) and MMT (IRR: 1.10, 95% CI: 1.02\u20101.18) were associated with longer LOS. Ninety\u2010day readmissions occurred in 9.3% of patients, highest in the mastoidectomy group (14.4%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.027). Intensive care unit (ICU) admission (adjusted odds ratio [aOR]: 3.98, 95% CI: 2.34\u20106.77), hematologic\/immunologic conditions (aOR: 3.17, 95% CI: 1.85\u20105.43), and malignancy (aOR: 7.94, 95% CI: 3.91\u201016.12) were predictors of readmission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This multi\u2010institutional study shows that surgical approach and disease severity correlate with pediatric AM outcomes. Findings support using validated administrative data in studying AM outcomes, addressing limitations of prior literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70049","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T12:49:25Z","timestamp":1760446165000},"page":"239-245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Outcomes of Acute Mastoiditis in Pediatric Patients: A Pediatric Health Information System Study"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1678-7548","authenticated-orcid":false,"given":"Shachi","family":"Srivatsa","sequence":"first","affiliation":[{"name":"Department of Surgery The Ohio State University Wexner Medical Center Columbus Ohio USA"},{"name":"Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6712-3550","authenticated-orcid":false,"given":"Brenna","family":"Rachwal","sequence":"additional","affiliation":[{"name":"Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taha","family":"Akbar","sequence":"additional","affiliation":[{"name":"Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Pennza","sequence":"additional","affiliation":[{"name":"Heritage College of Osteopathic Medicine Ohio University Dublin Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5420-6544","authenticated-orcid":false,"given":"Lindsey","family":"Asti","sequence":"additional","affiliation":[{"name":"Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital Columbus Ohio USA"},{"name":"Nemours Surgical Outcomes Center, Nemours Children's Health, Delaware Valley Wilmington Delaware USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8916-3732","authenticated-orcid":false,"given":"Peter C.","family":"Minneci","sequence":"additional","affiliation":[{"name":"Nemours Surgical Outcomes Center, Nemours Children's Health, Delaware Valley Wilmington Delaware 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