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Reflux as a Risk Factor for Morbidity after Pediatric Tonsillectomy: A National Cohort of Inpatients

Stephen R Chorney1,2, Karen B Zur1,2, Adva Buzi1,2

  • 1Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

The Laryngoscope
|July 19, 2020
PubMed

Insights

Gastroesophageal reflux (GER) increases inpatient complications and hospital stays for children undergoing tonsillectomy. Children with GER experience poorer outcomes, necessitating careful preoperative planning.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Gastroenterology

Background:

  • Gastroesophageal reflux (GER) is a known risk factor for adverse outcomes after pediatric tonsillectomy.
  • Understanding these risks is crucial for optimizing surgical care and patient management.

Purpose of the Study:

  • To investigate the impact of GER on outcomes following pediatric tonsillectomy.
  • To analyze hospitalization duration and associated costs in children with GER undergoing tonsillectomy.

Main Methods:

  • A retrospective cross-sectional study utilizing the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Databases (KID).
  • Data from 2012 and 2016 were analyzed for children undergoing tonsillectomy, comparing those with and without a GER diagnosis.

Main Results:

  • Children with GER (7.9%) had higher rates of respiratory complications, aspiration pneumonitis, and hypoxemia post-tonsillectomy.
  • Patients with GER experienced longer hospital admissions (3.8 vs. 2.3 days) and significantly higher total hospital charges ($47,129 vs. $27,584).
  • Reflux was a significant predictor of aspiration pneumonitis, hypoxemia, need for ventilation, and extended admission duration.

Conclusions:

  • Children with GER face significantly increased inpatient complications and longer hospital stays after tonsillectomy.
  • These findings underscore the importance of preoperative assessment and tailored management strategies for pediatric tonsillectomy patients with GER.
Abstract

Keywords:
Gastroesophageal reflux, hospital admission, morbidity, pediatrics, respiratory complications, tonsillectomy

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