title: Hospital admissions for respiratory symptoms and failure to thrive before and after Nissen fundoplication.
abstract: OBJECTIVE
  The purpose of this study is to determine whether Nissen fundoplication decreases hospital admissions for respiratory symptoms and failure to thrive (FTT).
  
  
  METHODS
  A retrospective study using discharge abstract data from Southern California Kaiser Permanente hospitals during the last decade was done. Three hundred forty-two pediatric patients had at least one Nissen fundoplication. Hospital admissions for aspiration and other pneumonia, respiratory distress/apnea, and FTT were determined before and after Nissen fundoplication. Age and associated neurologic disorders were also studied. Statistical analysis was determined by chi(2) analysis, Poisson regression analysis, and relative risk.
  
  
  RESULTS
  The number of patients requiring hospital admission for aspiration and other pneumonia, respiratory distress/apnea, and FTT was similar before and after Nissen fundoplication. The proportion of readmission within 1 year after Nissen fundoplication for aspiration pneumonia was 0.1250 (95% confidence interval [CI], 0.0266-0.3236); other pneumonia, 0.5465 (95% CI, 0.4355-0.6542); respiratory distress/apnea, 0.5039 (95% CI, 0.4145-0.5931); and FTT, 0.5669 (95% CI, 0.4761-0.6545). Associated neurologic disorders independently increased hospital admissions for aspiration and other pneumonia, respiratory distress/apnea, and FTT. Age was inversely related to hospital admissions for respiratory distress and FTT.
  
  
  CONCLUSIONS
  Nissen fundoplication did not improve hospital admissions for pneumonia, respiratory distress/apnea, and FTT. Associated neurologic disorders increased readmissions for pneumonia, respiratory distress/apnea, and FTT, whereas increasing age decreased readmission for respiratory distress and FTT.
authors.affiliation: Division of Pediatric Surgery, Department of General Surgery, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA 90027, USA. slleemd@yahoo.com
authors.forename: Steven L
authors.initials: SL
authors.lastname: Lee
authors.forename: Hooman
authors.initials: H
authors.lastname: Shabatian
authors.forename: Jin-Wen
authors.initials: JW
authors.lastname: Hsu
authors.forename: Harry
authors.initials: H
authors.lastname: Applebaum
authors.forename: Philip I
authors.initials: PI
authors.lastname: Haigh
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001049:Apnea; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005183:Failure to Thrive / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D012044:Regression Analysis; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D017678:Sex Distribution