New article you should know about from JPS by Dr. Cecilia Gigena
"Impact of Cryoanalgesia Use During Minimally Invasive Pectus Excavatum Repair on Hospital Days and Total Hospital Costs Among Pediatric Patients"
Authors: Brittany N. Hegde, Elenir Avritscher, Seyed A. Arshad, Elisa I. Garcia, Nutan B. Hebballi, Maryam Broussard, KuoJen Tsao
Full article: https://gcmd.co/3S4NBMB
Introduction
Surgical repair of pectus excavatum is a painful procedure requiring multimodal pain control with historically prolonged hospital stay. This study aimed to evaluate the impact of cryoanalgesia during minimally invasive repair of pectus excavatum (MIRPE) on hospital days (HDs), total hospital costs (HCs), and complications. We hypothesized that cryoanalgesia would be associated with reduced HDs and total HCs with no increase in post-operative complications.
Methods
We conducted a retrospective review of pediatric patients who underwent MIRPE from 2011 to 2021. MIRPE details and post-operative outcomes within 90 days were abstracted. Total HDs included the index MIRPE admission and readmissions within 90 days. HCs were obtained from the hospital accounting system, retroactively adjusting for medical inflation. Bayesian generalized linear models with neutral prior assuming no effect were used. Differences between treatment groups were assessed using gamma distribution (HDs and HCs) and poisson (post-operative complications). All models used log link and controlled for age, gender, race, and Haller index.
Results
Forty-four patients underwent MIRPE during the study period. Cryoanalgesia was utilized in 29 (66%) patients. The probability of a reduction with cryoanalgesia vs. no cryoanalgesia was 99% for HDs (3.0 vs. 5.4 days; Bayesian RR: 0.6, 95% CrI: 0.5–0.8), 89% for HCs ($18,787 vs. $19,667; RR: 0.9, 95% CrI: 0.8–1.1), and 70% for postoperative complications (17% vs 33%; RR: 0.8, 95% CrI: 0.3–1.9).
Conclusion
Cryoanalgesia use in MIRPE likely reduced HDs, HCs, and post-operative complications. Further research is warranted to confirm these findings in large prospective studies.
Type: video · 0 min · posted 2024-01-03 Canonical: https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862 ## Chapters - [0:00](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=0) Cryoanalgesia in Pectus Excavatum Repair: Study Overview ## Statements - "The study was a retrospective review conducted in Texas" — Cecilia Gigena (epidemiological) [0:11](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=11) - "The study aimed to evaluate hospital cost and length of stay for patients undergoing minimally invasive repair of pectus excavatum plus cryoanalgesia" — Cecilia Gigena (epidemiological) [0:11](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=11) - "The study included 44 patients total, with 29 undergoing cryoanalgesia" — Cecilia Gigena (epidemiological) [0:26](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=26) - "Patients who underwent cryoanalgesia had significantly less length of stay compared to those without cryoanalgesia" — Cecilia Gigena (clinical) [0:26](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=26) - "Patients who underwent cryoanalgesia had significantly lower complication rates compared to those without cryoanalgesia" — Cecilia Gigena (clinical) [0:26](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=26) - "Patients who underwent cryoanalgesia had lower hospital costs than those without cryoanalgesia, though this difference was not statistically significant" — Cecilia Gigena (clinical) [0:39](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=39) - "Cryoanalgesia helps with pain management in pectus excavatum repair" — Cecilia Gigena (opinion) [0:48](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=48) - "Cryoanalgesia can help with hospital cost reduction in pectus excavatum repair" — Cecilia Gigena (opinion) [0:48](https://library.globalcastmd.com/watch/impact-of-cryoanalgesia-use-during-minimally-invasive-pectus-excavatum-repair-on-hospital-days-and-total-hospital-costs-among-pediatric-patients-7862?t=48) ## Transcript Do you use cryoalgesia for the NAS procedure in pectus excavatum repair? Hi, I'm Cecilia Jigena from Cincinnati Children's Hospital, and I think this is an article that you should know about. This is a retrospective review done in Texas that aimed to evaluate the hospital cost and the length of stay of patients that underwent minimally invasive repair of pectus escabanum plus cryonalissia. And what did they find? They gathered 44 patients, 29 underwent cryonaltesia, and what they found is that patients that underwent cryo had significantly less length of stay and complications rates. And even it was not significant, they had less cost than those who underwent MRP without cryo. So it seems that cryo not only helps with pain management, but also can help with hospital cost. Let us know what you think and stay tuned for more articles that you should know about. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai