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Published on: November 6, 2019
Postoperative morbidity and mortality after adenoidectomy: A national population-based study of 51 746 surgeries
Hanna Gerhardsson1, Joacim Stalfors2, Ola Sunnergren1
1Department of Otorhinolaryngology, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Insights
Paediatric adenoidectomy is a safe procedure with very low complication rates. Studies found no deaths and rare instances of bleeding or infection, indicating a favorable safety profile for this common surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Public Health
Background:
- Adenoidectomy is a common surgical procedure in children.
- Understanding postoperative morbidity and mortality is crucial for patient safety.
Purpose of the Study:
- To investigate postoperative morbidity and mortality following paediatric adenoidectomy.
- To assess the safety profile of adenoidectomy in children.
Main Methods:
- Retrospective national population-based cohort study using Swedish registers (2007-2017).
- Inclusion of 51,746 paediatric patients (0-18 years) undergoing adenoidectomy without tonsil surgery.
- Analysis of diagnostic and surgical codes for healthcare contacts within 30 days and matching with death registers.
Main Results:
- No deaths directly related to adenoidectomy were identified.
- Hemorrhagic complications were rare: 0.1% outpatient visits and 0.1% readmissions for hemorrhage.
- Return to theatre (RTT) for hemorrhage occurred in only 0.01% of cases; postoperative infection was the most common complication.
Conclusions:
- Adenoidectomy is a safe surgical procedure with minimal postoperative complications.
- Severe complications, including hemorrhage, are rare, with most occurring within the first week post-surgery.
- Paediatric adenoidectomy demonstrates substantially lower postoperative morbidity compared to tonsil surgery.
Objectives:
To investigate postoperative morbidity and mortality after paediatric adenoidectomy.
Methods:
This was a retrospective national population-based cohort study of data from the Swedish National Patient Register (NPR) and The Swedish Cause of Death Register (CDR). All patients aged 0-18 years who underwent adenoidectomy from 2007 to 2017 (without concomitant tonsil surgery) were included in this study. To evaluate postoperative morbidity and mortality, all diagnostic and surgical codes registered in the NPR for health care contacts within 30 days of surgery were analysed. The patients retrieved from the NPR were matched with the CDR to identify any deaths occurring within 30 days of the surgery.
Results:
A total of 51 746 adenoidectomies were included in this study. No deaths related to adenoidectomy were identified. All types of haemorrhagic complications were rare. Only 0.1% of the surgeries resulted in an outpatient contact due to postoperative haemorrhage and only 0.1% of the adenoidectomies resulted in a readmission due to haemorrhage. The rarest haemorrhagic complication was RTT (return to theatre), with only 4 events (0.01%). Postoperative haemorrhage was most frequent on the first day after surgery. Other complications were rare as well, requiring a total of 922 (2.6%) outpatient visits and 75 (0.2%) readmissions in the adenoidectomy group, with postoperative infection being the most commonly reported.
Conclusions:
Overall, adenoidectomy should be considered a safe surgical procedure associated with few postoperative complications. No deaths related to adenoidectomy were found. Severe complications, such as late postoperative haemorrhage after adenoidectomy, were rare, and haemorrhage resulting in RTT was even rarer. The highest rate of postoperative haemorrhage was observed the first day after surgery, and most haemorrhagic complications occurred within a week. Comparisons with studies on tonsil surgery show that adenoidectomy is associated with substantially lower postoperative morbidity.
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