Faculty Collaboration Database

Gastroesophageal reflux as a predictor of complications after adenotonsillectomy in young children. Int J Pediatr Otorhinolaryngol 2013 Sep;77(9):1575-8

Date

08/14/2013

Pubmed ID

23938196

DOI

10.1016/j.ijporl.2013.07.012

Scopus ID

2-s2.0-84882578541 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

OBJECTIVE: To examine characteristics of young children with gastroesophageal reflux (GER) who experienced complications within the first 24h after adenotonsillectomy.

STUDY DESIGN: Subset analysis of a larger retrospective cohort.

METHODS: A retrospective chart review was performed at a tertiary care children's hospital. Consecutive records of children 3 years old and younger undergoing adenotonsillectomy (AT) over a 5-year period were reviewed. Children with a clinical history of GER were selected for the study.

RESULTS: 993 children were included in the initial analysis, and GER was found to be a significant independent variable predictive of early complications. 81 children with a history of GER were included in this study and 8 (9.9%) were found to have experienced complications within the first 24h. Six of the complications were airway-related; two required re-intubation within the first 24h. All 8 children with complications had symptoms of sleep-disordered breathing and two had documented severe obstructive sleep apnea (AHI 18.6 and 27.2). Seven children had other risk factors for complications after AT. Eighteen (22%) children had a prolonged length of stay (range 2-7 days); additional risk factors were present in these patients as well.

CONCLUSIONS: Knowledge of risk factors for complications following adenotonsillectomy is critical for identifying at-risk patients that may warrant closer post-operative observation. GER has been previously identified as a risk factor for complications in young children. Upon closer analysis, young children with GER who have other known risk factors may be at a further increased risk for airway complications and prolonged hospitalization. Parents of these children can be counseled on the post-operative risks and the possibility of a longer hospitalization.

Author List

McCormick ME, Sheyn A, Haupert M, 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
Female
Follow-Up Studies
Gastroesophageal Reflux
Hospitals, Pediatric
Humans
Incidence
Infant
Male
Monitoring, Physiologic
Postoperative Care
Postoperative Complications
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Tertiary Care Centers
Time Factors
Tonsillectomy
Treatment Outcome