Predictors of Complications of Tonsillectomy with or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010: A Population-Based Study

Veerajalandhar Allareddy, Natalia I Martinez Schlurmann, Sankeerth Rampa, Romesh P. Nalliah, Karen B. Lidsky, Veerasathpurush Allareddy, Alexandre T. Rotta

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1% were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7%), in large (bed-size) hospitals (LH, 57.8%), and in those who were electively admitted (EA, 67.3%). Frequently present CMC in patients included obstructive sleep apnea (OSA, 26.4%), chronic pulmonary disease (CPD, 14.6%), neurological disorders (ND, 6.7%), and obesity (4.8%). Majority of patients were discharged routinely (98%). Overall complication rate was 6.4% with common complications being postoperative pneumonia (2.3%), bacterial infections (1.4%), respiratory complications (1.3%), and hemorrhage (1.2%). All-cause mortality included a total of 60 patients. Patients in TH (odds ratio [OR] = 0.72, 95%CI = 0.62-0.85), LH (OR = 0.80, 95% CI = 0.69-0.93), and those who had the procedures during EA (OR = 0.64, 95% CI = 0.56-0.74) had significantly lower odds of complications compared with their counterparts. CMC such as anemia, CPD, coagulopathy, HT, ND, and fluid/electrolyte disorders were independent predictors of significantly higher complication risk (P <.05). In conclusion, hospitalized children who underwent tonsillectomy (w/woA) in large or teaching hospitals, or during elective admissions had lower risk of complications. Comorbidity is an important independent predictor of complications in this cohort.

Original languageEnglish (US)
Pages (from-to)593-602
Number of pages10
JournalClinical Pediatrics
Volume55
Issue number7
DOIs
StatePublished - Jun 1 2016

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Hospitalized Adolescent
Adenoidectomy
Hospitalized Child
Tonsillectomy
Population
Odds Ratio
Teaching Hospitals
Hospital Bed Capacity
Logistic Models
Obstructive Sleep Apnea
Nervous System Diseases
Bacterial Infections
Electrolytes
Lung Diseases
Comorbidity
Anemia
Inpatients
Pneumonia
Chronic Disease
Obesity

Keywords

  • Adenoidectomy
  • Comorbidity
  • Complications
  • Hospitalization
  • Tonsillectomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Predictors of Complications of Tonsillectomy with or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010 : A Population-Based Study. / Allareddy, Veerajalandhar; Martinez Schlurmann, Natalia I; Rampa, Sankeerth; Nalliah, Romesh P.; Lidsky, Karen B.; Allareddy, Veerasathpurush; Rotta, Alexandre T.

In: Clinical Pediatrics, Vol. 55, No. 7, 01.06.2016, p. 593-602.

Research output: Contribution to journalReview article

Allareddy, Veerajalandhar ; Martinez Schlurmann, Natalia I ; Rampa, Sankeerth ; Nalliah, Romesh P. ; Lidsky, Karen B. ; Allareddy, Veerasathpurush ; Rotta, Alexandre T. / Predictors of Complications of Tonsillectomy with or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010 : A Population-Based Study. In: Clinical Pediatrics. 2016 ; Vol. 55, No. 7. pp. 593-602.
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title = "Predictors of Complications of Tonsillectomy with or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010: A Population-Based Study",
abstract = "Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1{\%} were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7{\%}), in large (bed-size) hospitals (LH, 57.8{\%}), and in those who were electively admitted (EA, 67.3{\%}). Frequently present CMC in patients included obstructive sleep apnea (OSA, 26.4{\%}), chronic pulmonary disease (CPD, 14.6{\%}), neurological disorders (ND, 6.7{\%}), and obesity (4.8{\%}). Majority of patients were discharged routinely (98{\%}). Overall complication rate was 6.4{\%} with common complications being postoperative pneumonia (2.3{\%}), bacterial infections (1.4{\%}), respiratory complications (1.3{\%}), and hemorrhage (1.2{\%}). All-cause mortality included a total of 60 patients. Patients in TH (odds ratio [OR] = 0.72, 95{\%}CI = 0.62-0.85), LH (OR = 0.80, 95{\%} CI = 0.69-0.93), and those who had the procedures during EA (OR = 0.64, 95{\%} CI = 0.56-0.74) had significantly lower odds of complications compared with their counterparts. CMC such as anemia, CPD, coagulopathy, HT, ND, and fluid/electrolyte disorders were independent predictors of significantly higher complication risk (P <.05). In conclusion, hospitalized children who underwent tonsillectomy (w/woA) in large or teaching hospitals, or during elective admissions had lower risk of complications. Comorbidity is an important independent predictor of complications in this cohort.",
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T1 - Predictors of Complications of Tonsillectomy with or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010

T2 - A Population-Based Study

AU - Allareddy, Veerajalandhar

AU - Martinez Schlurmann, Natalia I

AU - Rampa, Sankeerth

AU - Nalliah, Romesh P.

AU - Lidsky, Karen B.

AU - Allareddy, Veerasathpurush

AU - Rotta, Alexandre T.

PY - 2016/6/1

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N2 - Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1% were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7%), in large (bed-size) hospitals (LH, 57.8%), and in those who were electively admitted (EA, 67.3%). Frequently present CMC in patients included obstructive sleep apnea (OSA, 26.4%), chronic pulmonary disease (CPD, 14.6%), neurological disorders (ND, 6.7%), and obesity (4.8%). Majority of patients were discharged routinely (98%). Overall complication rate was 6.4% with common complications being postoperative pneumonia (2.3%), bacterial infections (1.4%), respiratory complications (1.3%), and hemorrhage (1.2%). All-cause mortality included a total of 60 patients. Patients in TH (odds ratio [OR] = 0.72, 95%CI = 0.62-0.85), LH (OR = 0.80, 95% CI = 0.69-0.93), and those who had the procedures during EA (OR = 0.64, 95% CI = 0.56-0.74) had significantly lower odds of complications compared with their counterparts. CMC such as anemia, CPD, coagulopathy, HT, ND, and fluid/electrolyte disorders were independent predictors of significantly higher complication risk (P <.05). In conclusion, hospitalized children who underwent tonsillectomy (w/woA) in large or teaching hospitals, or during elective admissions had lower risk of complications. Comorbidity is an important independent predictor of complications in this cohort.

AB - Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1% were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7%), in large (bed-size) hospitals (LH, 57.8%), and in those who were electively admitted (EA, 67.3%). Frequently present CMC in patients included obstructive sleep apnea (OSA, 26.4%), chronic pulmonary disease (CPD, 14.6%), neurological disorders (ND, 6.7%), and obesity (4.8%). Majority of patients were discharged routinely (98%). Overall complication rate was 6.4% with common complications being postoperative pneumonia (2.3%), bacterial infections (1.4%), respiratory complications (1.3%), and hemorrhage (1.2%). All-cause mortality included a total of 60 patients. Patients in TH (odds ratio [OR] = 0.72, 95%CI = 0.62-0.85), LH (OR = 0.80, 95% CI = 0.69-0.93), and those who had the procedures during EA (OR = 0.64, 95% CI = 0.56-0.74) had significantly lower odds of complications compared with their counterparts. CMC such as anemia, CPD, coagulopathy, HT, ND, and fluid/electrolyte disorders were independent predictors of significantly higher complication risk (P <.05). In conclusion, hospitalized children who underwent tonsillectomy (w/woA) in large or teaching hospitals, or during elective admissions had lower risk of complications. Comorbidity is an important independent predictor of complications in this cohort.

KW - Adenoidectomy

KW - Comorbidity

KW - Complications

KW - Hospitalization

KW - Tonsillectomy

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