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Post-tonsillectomy outcomes in children with mucopolysaccharidosis and obstructive sleep apnea

Zachary Elwell1, David Mancuso2, Nikolaus E Wolter3

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Arizona College of Medicine - Tucson, 1501 N Campbell Ave, Tucson, AZ, 85724, USA. zaelwell@arizona.edu.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|December 23, 2023
PubMed

Insights

Children with mucopolysaccharidosis (MPS) undergoing adenotonsillectomy (AT) face higher risks of respiratory issues and bleeding. These patients also experience longer hospital stays and increased treatment costs compared to their peers.

Area of Science:

  • Pediatric Surgery
  • Genetics and Inherited Diseases
  • Healthcare Management

Background:

  • Mucopolysaccharidosis (MPS) is a group of rare genetic disorders affecting multiple organ systems.
  • Adenotonsillectomy (AT) is a common surgical procedure in children, but may pose unique risks for those with underlying conditions like MPS.

Purpose of the Study:

  • To determine the incidence of respiratory complications and postoperative hemorrhage in children with MPS undergoing AT.
  • To compare the length of hospital stay and associated costs for children with and without MPS who undergo AT.

Main Methods:

  • Analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database (HCUP KID) for 2009, 2012, and 2016.
  • Comparison of outcomes (respiratory complications, hemorrhage, length of stay, cost) between 40 children with MPS and 24,660 children without MPS who underwent AT.

Main Results:

  • Children with MPS had significantly higher rates of respiratory complications (15% vs. 2.4%) and postoperative hemorrhage (10% vs. 1.8%) compared to controls.
  • The median length of hospital stay was longer for children with MPS (3 days vs. 1 day).
  • Hospital charges were substantially higher for children with MPS ($33,016 vs. $15,383).

Conclusions:

  • Children with MPS undergoing AT experience increased risks for respiratory complications and postoperative hemorrhage.
  • The findings indicate a longer length of stay and higher treatment costs for pediatric patients with MPS undergoing AT.
  • This data can inform perioperative and postoperative care strategies for children with MPS requiring AT.
Abstract

Keywords:
AdenotonsillectomyMucopolysaccharidosisPostoperative complications

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