Hospital revisits after paediatric tonsillectomy: a cohort study

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Health Services Research

Background:

• Tonsillectomy and adenotonsillectomy are leading causes of unplanned pediatric hospital readmissions.
• Potentially avoidable readmissions impact patient safety and healthcare resources.
• This study investigates surgery-related hospital revisits following pediatric tonsillectomy and adenotonsillectomy.

Purpose of the Study:

• To determine the incidence and timing of hospital revisits after pediatric tonsillectomy and adenotonsillectomy.
• To identify risk factors associated with surgery-related hospital revisits.
• To inform strategies for reducing unplanned hospital readmissions.

Main Methods:

• Population-based cohort study using linked administrative data from Victoria, Australia (2010-2015).
• Included all pediatric tonsillectomy and adenotonsillectomy surgeries.
• Primary outcome: emergency department presentation or hospital readmission within 30 days post-surgery.

Main Results:

• Over 47,000 surgeries were analyzed, with 10.11% resulting in emergency department presentations and 5.84% in readmissions.
• Hemorrhage was the most frequent cause for both emergency visits (3.34%) and readmissions (3.97%).
• Median revisit time was Day 5; risk factors included older age, public/metropolitan hospitals, and peri-operative complications.

Conclusions:

• Hemorrhage is the primary driver of emergency department visits and readmissions post-tonsillectomy/adenotonsillectomy.
• Increased revisit risk in older children, public/metropolitan hospitals, and with peri-operative complications.
• Recommendations include enhanced caregiver education and judicious discharge planning to mitigate risks.