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Adenoidectomy: Inpatient criteria study.

Ravi Patel¹, Neha A Patel², Guillaume Stoffels³

¹Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Otolaryngology-Head and Neck Surgery, Hempstead, NY, USA.

American Journal of Otolaryngology

|November 5, 2020

Summary

Pediatric adenoidectomy patients under two years old with major comorbidities may need overnight observation. Otherwise healthy children over 18 months can often be discharged the same day after adenoidectomy.

Keywords:

Adenoidectomy Inpatient criteria OSA Obstructive sleep apnea Outcomes SDB Sleep-disordered breathing

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Area of Science:

Pediatric Otolaryngology
Surgical Outcomes Research
Patient Safety

Background:

Adenoidectomy practices for overnight observation vary widely in pediatric care.
No current evidence-based guidelines exist for post-adenoidectomy observation criteria.

Purpose of the Study:

To identify risk factors associated with postoperative complications after adenoidectomy in young children.
To develop guidelines for stratifying patients for inpatient observation post-adenoidectomy.

Main Methods:

Retrospective review of electronic medical records for pediatric adenoidectomy cases (children <2 years old).
Analysis of patient demographics, surgical data, and comorbidities.
Correlation of risk factors with postoperative complications and interventions.

Main Results:

One out of 76 patients (1.3%) required readmission for dehydration; seven (9.2%) required intervention.
Major comorbidities significantly increased complication/intervention rates (18.9% vs. 2.6%).
Significant risk factors included low O2 nadir (<80%), craniofacial syndrome, and seizure history.

Conclusions:

Healthy children over 18 months with sleep-disordered breathing may be discharged same-day post-adenoidectomy.
Children under 2 years with one or more major comorbidities may benefit from overnight observation.
Infants under 18 months or those with RAD/CLD require individualized assessment.