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A Method to Study Adaptation to Left-Right Reversed Audition
Published on: October 29, 2018
Tertiary hospital retrospective observational audit of tonsillectomy
Hannah Ng1, Eugene Wong2, John Curotta3
1University of Auckland, New Zealand.
Insights
Tonsillectomy complications and hospital stay are impacted by patient age and obesity. Obese children experienced more desaturation events, and comorbidities increased hospital length of stay.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Health Services Research
Background:
- Tonsillectomy is a common procedure for pediatric airway symptoms.
- Patient-specific factors may influence postoperative outcomes and hospital resource utilization.
Purpose of the Study:
- To investigate the impact of patient factors, including BMI and obstructive sleep apnea (OSA), on postoperative morbidities.
- To analyze the effect of these factors on hospital stay length following tonsillectomy.
Main Methods:
- Retrospective chart review of pediatric patients undergoing tonsillectomy from July 2010 to July 2014.
- Analysis of 420 patient records, including comorbidities, BMI, and polysomnogram (PSG) data.
- Comparison of complication rates and hospital stay duration based on patient characteristics.
Main Results:
- 20% of patients experienced postoperative complications; complication rates were highest in children under 2 years.
- Obese patients had a statistically significant increase in desaturation-related complications (p=0.00480).
- Children with comorbidities had significantly longer hospital stays (p=0.00607 and p=0.00167).
Conclusions:
- Age, obesity, and comorbidities significantly impact postoperative complications and hospital length of stay after pediatric tonsillectomy.
- These factors contribute to increased hospital resource utilization and costs.
- Identifying high-risk patients preoperatively can aid in resource planning and management.
Objectives:
Tertiary hospitals see a wide array of complex paediatric patients requiring the procedure of tonsillectomy to alleviate airway symptoms. To investigate the implications of patient-specific factors on postoperative morbidities and hospital stay length, including the role of BMI and AH as predictors for airway complications following surgery.
Methods:
A retrospective chart review was performed for all patients presenting at The Children's Hospital at Westmead for routine tonsillectomy between July 2010 and July 2014.
Results:
Of 500 charts, 420 patients met inclusion criteria. 155 (37%) patients had a pre-existing comorbidity. Polysomnogram (PSG) was conducted prior to surgery (n = 129). BMI results showed a mean BMI of 20.0, n = 25 were overweight, n = 70 were obese and n = 11 underweight. 84 patients (20%) experienced a postoperative complication/unexpected morbidity. There were no returns to theatre and no mortality. 24 patients had more than one complication. Complication rate was highest in the patients <2 years of age. There was a statistically significant difference in the number of desaturation related complications between obese and non-obese groups p = 0.00480. There was statistically significant difference in length of hospital stay between the two groups. 16% of children with co-morbidities stayed for >2 nights in hospital (25/155) compared to 7.5% of children without co-morbidities p = 0.00607. 9% of children with co-morbidities stayed for 3 nights in hospital (14/155) compared to patients without co-morbidities (6/256), p = 0.00167.
Conclusions:
This audit confirms the impact of age, obesity and certain co-morbidities on the potential costs to the hospital in managing complications and length of stay after surgery.
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