Faculty Collaboration Database

Predicting complications after adenotonsillectomy in children 3 years old and younger. Int J Pediatr Otorhinolaryngol 2011 Nov;75(11):1391-4

Date

09/06/2011

Pubmed ID

21889216

DOI

10.1016/j.ijporl.2011.07.035

Scopus ID

2-s2.0-80053958661 (requires institutional sign-in at Scopus site)   40 Citations

Abstract

OBJECTIVES: To identify risk factors for complications in the first 24h after surgery in the young (<4 years old) adenotonsillectomy patient.

METHODS: A retrospective chart review was performed at a tertiary care children's hospital. Consecutive records of all children of age 3 years and younger undergoing adenotonsillectomy over a 5 year period were included in the study. The main outcomes measured were total and airway complications occurring on post-operative days 0-1.

RESULTS: 993 patients were included in the study. The mean age was 2.94 years old. Witnessed apneas (74.1%) and snoring (59.2%) were the most frequent pre-operative symptoms. 700 children were admitted with a mean length-of-stay of 1.22 days (0-9 days) and a mean time-to-oral intake of 0.28 days (0-4 days) among those patients admitted. The total number of complications was 102 in 98 patients (9.9%). There were 35 complications on post-operative days (POD) 0-1 (3.5%), and 23 of those were airway-related (2.3%). With regard to all complications on POD 0-1, significant predictors were nasal obstruction, gastroesophageal reflux disease, prematurity and a history of cardiovascular anomalies. Significant predictors of airway complications on POD 0-1 were younger age (1-2 years old), larger adenoid size, nasal obstruction, and a history of cardiovascular anomalies.

CONCLUSIONS: Knowing the stated risk factors for complications in the early post-operative period after adenotonsillectomy in the younger pediatric patient can help select certain patients for closer monitoring. Specifically, children aged 1-2 years old with a history of nasal obstruction from large adenoids, gastroesophageal reflux disease, prematurity, and/or cardiovascular anomalies appear to be at higher risk for early complications and should warrant closer observation.

Author List

McCormick ME, Sheyn A, Haupert M, Thomas R, Folbe AJ

Author

Michael E. McCormick MD Associate Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenoidectomy
Age Factors
Airway Obstruction
Child, Preschool
Cohort Studies
Confidence Intervals
Female
Follow-Up Studies
Humans
Logistic Models
Male
Monitoring, Physiologic
Odds Ratio
Patient Selection
Postoperative Care
Postoperative Complications
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Statistics, Nonparametric
Time Factors
Tonsillectomy
Treatment Outcome