There are a significant number of pediatric patients who have tonsillectomy and adenoidectomy (T&A) in ambulatory settings despite the higher rates of complications in younger patients and patients with more comorbidities, according to recently published research.
The researchers say that a large number of pediatric T&A patients have been triaged to the inpatient setting, which they say is appropriate. More research is needed to clarify which subgroups need postop hospitalization, according to the study in JAMA Otolaryngology – Head & Neck Surgery. The researchers were from Stanford (CA) University.
The purpose of this study was to determine risk factors for postoperative complications based on age and facility type among children undergoing T&A. The study looked at 115,214 children who had T&A in hospitals, hospital-based facilities (HBFs), and freestanding facilities (FSFs) in California from 2005 to 2010. The researchers used state data. There were 18,622 inpatients and 96,592 outpatients. The inpatients had a mean age of 5.4, and the ambulatory patients had a mean age of 7.6.
Inpatients had more comorbidities (eight or fewer, compared with four or fewer for HBFs and three or fewer for FSFs). Generally, inpatients had higher complication rates than patients at HBFs (2-5 times higher) and FSFs (more than 10 times higher).
T&A had an increased risk for all types of complication in both settings, the researchers said. Inpatients who were ages 0 to 9 years had higher rates of airway and respiratory complications. (To view the abstract, go to bit.ly/1nd337d.)
