Prolonged hospitalization following tonsillectomy in healthy children

To determine the incidence and factors that influence prolonged hospitalization in healthy children following tonsillectomy.

A retrospective analysis was performed of all the children who underwent tonsillectomy with or without other otolaryngological procedures in a tertiary care center. Analysis were carried out on otherwise healthy children who were unexpectedly hospitalized for two nights or more to identify factors that influenced their length of stay as well as readmission to hospital.

Out of a total of 1229 children who underwent tonsillectomy within the study period, there were 1129 children who had no significant co-morbidities. Within this group a total of 73 (6.5%) children were unexpectedly hospitalized for two nights or more. There were 45 (62%) males and 28 (38%) females with a mean age of 5.3 yr and mean length of stay of 2.7 days. The most common reasons for prolonged hospitalization were poor oral intake and fever. While gender was not a risk factor, these children were younger compared with those discharged within 24h (5.3 yr versus 6.2 yr, p-value of 0.046). Nine of the children (12%) who required prolonged hospitalization were readmitted, which is significantly higher compared with the readmission rate of 3.9% in children who were discharged within 24h (p-value<0.001). Delayed hemorrhage was the principle cause of readmission.

A significant proportion of otherwise healthy children require prolonged hospitalization following overnight-stay tonsillectomy. It is unclear whether planned discharge on day of surgery would be beneficial in lowering this rate.