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An observational pragmatic quality-of-life study on paediatric tonsillectomy and waiting for surgery
Julie Huynh1,2, Charmaine M Woods3,4, Eng H Ooi3,4
1Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia. julie.huynh@sa.gov.au.
Insights
Pediatric tonsillectomy significantly improves children's quality of life long-term, but no benefits are seen while awaiting surgery. Reducing wait times could improve patient welfare.
Area of Science:
- Otolaryngology
- Pediatric Health
- Quality of Life Research
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Assessing quality of life (QoL) impacts is crucial for optimizing surgical care.
- Parental perceptions offer valuable insights into a child's surgical journey.
Purpose of the Study:
- To evaluate parental perceptions of tonsillectomy's effect on pediatric quality of life.
- To compare QoL during the waiting period versus post-surgery.
- To inform healthcare practices within the Australian public health system.
Main Methods:
- Observational pragmatic study at a tertiary Australian hospital.
- 167 parents of pediatric patients (2-16 years) awaiting tonsillectomy participated.
- Validated T-14 questionnaire administered at multiple time points: pre-surgery, day of surgery, 6 weeks, and 6 months post-op.
Main Results:
- Median wait time for surgery was 174 days.
- No significant QoL change observed while awaiting surgery (median T-14 scores: 35 vs 36).
- Significant QoL improvement at 6 weeks post-op (median T-14 scores: 33.5 vs 2), sustained at 6 months (median T-14 scores: 2 vs 0).
Conclusions:
- Pediatric tonsillectomy leads to sustained long-term improvements in quality of life.
- Quality of life does not improve during the waiting period for tonsillectomy.
- Reducing surgical waiting times is recommended to enhance pediatric patient welfare.
Purpose:
To investigate parental perceptions of the effects of tonsillectomy on their child's quality of life while awaiting and following surgery in an Australian public health system.
Methods:
An observational pragmatic study was undertaken at a tertiary Australian hospital. Parents of paediatric patients (2-16 years of age) listed for tonsillectomy completed a validated quality-of-life questionnaire (T-14 Paediatric Throat Disorders Outcome Test) at the initial consultation, on day of surgery, 6 weeks post-operatively and 6 months post-operatively. T-14 scores were compared using the Related-Samples Wilcoxon Signed Rank Test.
Results:
Parents of 167 children participated in this study. There was a median wait time of 174 days (IQR 108-347) from the initial consultation until the day of surgery, with no significant change in median T-14 scores (35 [IQR 22-42] vs 36 [IQR 22-42]; n = 63; p > 0.05). There was a significant decrease from pre-operative T-14 scores to 6 weeks post-operatively (33.5 [IQR 22-42] vs 2 [IQR 0-5]; n = 160; p < 0.001), and this was sustained with a minor improvement at 6 months post-operatively (6 weeks 2 [IQR 0-5] vs 6 months 0 [IQR 0-2]; n = 148; p < 0.001).
Conclusions:
Paediatric tonsillectomy improves quality of life with a sustained benefit in the long term. There is no improvement to the patient's quality of life while awaiting tonsillectomy, thus patient welfare can be improved through reducing waiting times for surgery.
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