• Langue : Français
• Discipline : Médecine. ORL et Chirurgie cervico-faciale
• Identifiant : 2019LILUM232
• Type de thèse : Doctorat de médecine
• Date de soutenance : 27/06/2019

Résumé en langue originale

Objectives : to describe hospital admissions in relation with acute otitis media (AOM) complications, to identify the evolution of complicated AOM, and to identify risk factors of severity or pejorative evolution. Material: population-based, retrospective cohort study using data extracted from the PMSI database, for hospital discharges of all patients admitted for a complicated AOM in France from January 1, 2008 to December 31, 2014 and aged <15 years. Results: 5787 patients with complicated AOM were identified including 1683 (29.1%) severe complicated AOM. The incidence of complicated AOM ranged from 1.23 to 1.43 per 100,000 inhabitants. No trend could be identified regarding the total number of complicated AOM. The number of severe complicated AOM significantly increased over time (from 161 stays in 2008 to 258 stays in 2014; p=0). Age <3 months (OR=2.99 [2.04; 4.38]); was identified as risk factors of having a severe complicated AOM. Meningitis (HR=5.02 [2.38; 10.6]), labyrinthitis (HR=4.51 [1.62; 12.5]), and an age ranging from 3 months to 2 years (HR=2.44 [1.21; 4.89]) were identified as risk factors of cochlear implantation. Intracranial venous thrombosis (OR=3.78 [2.6; 5.49]), empyema (OR=3.94 [2.73; 5.7]), meningitis (OR=1.34 [1.06; 1.69]), children aged less than 3 months (OR=1.83 [1.05; 3.16]), and 3 months - 2 years (OR=1.82 [1.48; 2.22]) were identified as risk factors of readmission within 30 days. Conclusion: Complicated AOM remains a rare disease in France, and the incidence of severe complications has increased over time. Age seems to be related to the risk of severe complications. Age, as well as some complications, are related to the risk of early readmission and severe hearing loss.

Résumé traduit

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