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Outcomes and considerations in children with developmental delay undergoing tonsillectomy.

Jordan B Luttrell1, Chad A Nieri1, Madhu Mamidala1

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Children with developmental delay (DD) face significantly higher post-tonsillectomy complication rates. This highlights the need to incorporate DD into pre-operative risk assessments and patient counseling for improved surgical outcomes.

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Area of Science:

  • Pediatric Surgery
  • Developmental Pediatrics
  • Healthcare Outcomes Research

Background:

  • Developmental delay (DD) affects 1 in 6 children, leading to increased healthcare utilization.
  • Children with DD may experience a higher rate of complications and costs.
  • Tonsillectomy is a common procedure in children, necessitating an understanding of associated risks.

Purpose of the Study:

  • To compare post-operative complications in children with and without developmental delay (DD) undergoing tonsillectomy.
  • To identify specific risk factors and comorbidities associated with DD in this patient population.
  • To inform pre-operative counseling and decision-making for children with DD.

Main Methods:

  • Retrospective chart review of 400 children undergoing tonsillectomy over one year.
  • Data collected included demographics, polysomnograms, comorbidities, complications, and length of stay.
  • Children with a pre-existing or ongoing diagnosis of DD were compared to controls.

Main Results:

  • The developmental delay (DD) group (n=56) had a significantly higher complication rate (32.14%) compared to controls (8.72%) (p < 0.00001).
  • Children with DD exhibited higher incidences of comorbidities (p < 0.00001) and prematurity (p < 0.00001).
  • No significant difference in length of stay (p=0.33) or complications if premature (p=0.22) was observed between groups.

Conclusions:

  • Children with DD face substantially higher risks of post-tonsillectomy complications.
  • The increased risk is linked to higher rates of comorbidities and prematurity in the DD population.
  • Findings underscore the importance of including DD in pre-operative evaluations and counseling for this high-risk group.