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The association between pediatric general emergency department visits and post operative adenotonsillectomy hospital
John N Bangiyev1, Prasad J Thottam1, Jennifer R Christenson1
1Detroit Medical Center, Department of Otolaryngology, Head and Neck Surgery, United States; Children's Hospital of Michigan, Department of Otolaryngology, Head and Neck Surgery, United States.
Insights
Pediatric patients with pre-operative emergency department (ED) visits, female gender, or recurrent strep tonsillitis diagnosis were more likely to return to the ED post-adenotonsillectomy. This highlights key risk factors for post-operative care.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Emergency Medicine
Background:
- Adenotonsillectomy is a common pediatric surgical procedure.
- Post-operative emergency department (ED) visits can indicate complications or suboptimal care.
- Identifying predictors of post-operative ED return is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the association between pre-operative factors and post-operative ED return after adenotonsillectomy.
- Specifically examining the role of pre-operative ED visits, gender, and pre-operative diagnosis.
Main Methods:
- Retrospective chart review of 1468 pediatric patients.
- Data collected from a tertiary pediatric hospital between 2011 and 2013.
- Analysis focused on pre-operative ED visits, gender, and diagnosis in relation to post-operative ED visits.
Main Results:
- Patients with pre-operative ED visits had a significantly higher rate of post-operative ED return (25% vs. 10%).
- Female gender and a pre-operative diagnosis of recurrent strep tonsillitis were also significantly associated with post-operative ED visits.
- Statistical significance was noted for pre-operative visits (p<0.001), gender (p=0.04), and diagnosis (p=0.002).
Conclusions:
- Pre-operative emergency department visits are a significant predictor of post-operative ED return after adenotonsillectomy.
- Female gender and recurrent streptococcal tonsillitis diagnosis are also associated with increased post-operative ED utilization.
- These findings can inform strategies to mitigate post-operative ED visits in pediatric patients.
Purpose:
To define the association between pre-operative general emergency department visits, gender, and pre-operative diagnosis with post-operative emergency department return following adenotonsillectomy.
Methods:
Retrospective chart review of 1468 pediatric patients who underwent adenotonsillectomy at a tertiary pediatric hospital between 2011 and 2013.
Results:
There was a significant relationship between patients who visited the ED pre-operatively, 25% (N=96) returned to the ED post-procedure, compared to 10% who did not have a pre-operative ED visit. There was an overall significant relation between having a pre-operative visit (χ(2)=53.6, df=1, p<0.001), female gender (female=56.9%; male=43.1%; χ(2)=4.2, df=1, p=0.04), and having a preoperative diagnosis of recurrent strep tonsillitis (OSA and RST=18%; RST=17.5%; OSA=11.8%; χ(2)=12.8, p=0.002) and having a post-operative ED visit.
Conclusion:
Generalized pre-operative visits along with gender and diagnosis of recurrent streptococcal tonsillitis were found to be positively associated with post-operative ED visits for common post-operative complaints.
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