Factors Influencing Postoperative Emergency Department Visits After Adenotonsillectomy in Pediatric Patients

This study investigates the relationship between preoperative factors and postoperative outcomes, particularly emergency department (ED) visits, in pediatric patients following adenotonsillectomy. It primarily focuses on the length of hospital stay in the procedure outcomes. The goal was to identify ways to reduce unexpected ED visits and poor outcomes after the procedure.

A retrospective analysis was conducted on pediatric patients aged 2-14 who underwent adenotonsillectomy at King Abdullah Specialized Children's Hospital (KASCH) between 2016 and 2023. Data were extracted from the BestCare database, including demographics, surgery-related factors, length of hospital stay, and postoperative outcomes such as ED visits, complications, and readmissions.

The study included 700 adenotonsillectomy cases, with an average hospital stay of 1.0 days (1.0-9.0). Within 90 days post-surgery, there were 227 ED visits, with pain accounting for 29.5% of cases. Patients with a hospital stay of one day or more were more likely to experience ED visits (p = 0.030) and postoperative bleeding (p = 0.027), while those discharged in less than a day had lower readmission rates (p = 0.002). There was a direct correlation between the number of admission days followed by the procedure and the frequency of ED visits. Patients who had surgery for obstructive reasons or were prescribed sodium chloride nasal drops or penicillin at discharge (p = 0.014) had fewer postoperative ED visits (p = 0.010), respectively.

The study identified several preoperative factors and hospital stay durations that impact ED visit frequency after adenotonsillectomy. These findings underscore the importance of individualized postoperative care to reduce complications and ED visits in pediatric patients.