A Cross-sectional Analysis of Pediatric Ambulatory Tonsillectomy Surgery in the United States

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Abstract

Objectives: To report nationwide estimates of ambulatory tonsillectomies performed in hospitals and ambulatory surgery centers in the United States. Study Design: Cross-sectional survey. Setting: National databases. Subjects and Methods: We analyzed the 2010 National Hospital Ambulatory Medical Care Survey of hospitals and ambulatory surgery centers for pediatric patients undergoing tonsillectomy with or without adenoidectomy. We determined estimations of the number of procedures, demographics, and outcomes. A tonsillectomy cohort from the 2009 National Inpatient Sample served as a comparison group. Results: In 2010, there were an estimated 339,000 (95% CI, 288,000-391,000) ambulatory tonsillectomies in the United States. The mean age was 7.8 years (SD, 5.1), and 71,000 (21.0%) were <3 years old. The male:female ratio was even (51% vs 49%). The racial makeup mirrored the US census (69% white, 18% Hispanic, and 12% black). Obstructive sleep-disordered breathing was reported in 48%. Perioperative events such as apnea, hypoxia, or bleeding occurred 7.8% of the time. Approximately 9% of patients could not be discharged home. When compared with cases of inpatient tonsillectomies, ambulatory cases comprised older patients (7.8 vs 5.9 years, P <.001) and were less likely to include obstructive sleep-disordered breathing (48% vs 77%, P <.001). Conclusion: Tonsillectomy was one of the most common ambulatory surgical procedures in 2010 in the United States. The majority of patients were low risk, but some at higher risk were included (age ≤3 years and obstructive sleep apnea). The National Hospital Ambulatory Medical Care Survey estimates provide useful baseline data for future research on quality measures and outcomes.

Original languageEnglish (US)
JournalOtolaryngology - Head and Neck Surgery (United States)
DOIs
StatePublished - Jan 1 2019

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Tonsillectomy
Ambulatory Surgical Procedures
Cross-Sectional Studies
Pediatrics
Health Care Surveys
Sleep Apnea Syndromes
Inpatients
Adenoidectomy
Obstructive Sleep Apnea
Apnea
Censuses
Hispanic Americans
Demography
Outcome Assessment (Health Care)
Databases
Hemorrhage

Keywords

  • ambulatory
  • tonsillectomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

@article{d2f1eef96d974b1cb3c99c8cb79378dd,
title = "A Cross-sectional Analysis of Pediatric Ambulatory Tonsillectomy Surgery in the United States",
abstract = "Objectives: To report nationwide estimates of ambulatory tonsillectomies performed in hospitals and ambulatory surgery centers in the United States. Study Design: Cross-sectional survey. Setting: National databases. Subjects and Methods: We analyzed the 2010 National Hospital Ambulatory Medical Care Survey of hospitals and ambulatory surgery centers for pediatric patients undergoing tonsillectomy with or without adenoidectomy. We determined estimations of the number of procedures, demographics, and outcomes. A tonsillectomy cohort from the 2009 National Inpatient Sample served as a comparison group. Results: In 2010, there were an estimated 339,000 (95{\%} CI, 288,000-391,000) ambulatory tonsillectomies in the United States. The mean age was 7.8 years (SD, 5.1), and 71,000 (21.0{\%}) were <3 years old. The male:female ratio was even (51{\%} vs 49{\%}). The racial makeup mirrored the US census (69{\%} white, 18{\%} Hispanic, and 12{\%} black). Obstructive sleep-disordered breathing was reported in 48{\%}. Perioperative events such as apnea, hypoxia, or bleeding occurred 7.8{\%} of the time. Approximately 9{\%} of patients could not be discharged home. When compared with cases of inpatient tonsillectomies, ambulatory cases comprised older patients (7.8 vs 5.9 years, P <.001) and were less likely to include obstructive sleep-disordered breathing (48{\%} vs 77{\%}, P <.001). Conclusion: Tonsillectomy was one of the most common ambulatory surgical procedures in 2010 in the United States. The majority of patients were low risk, but some at higher risk were included (age ≤3 years and obstructive sleep apnea). The National Hospital Ambulatory Medical Care Survey estimates provide useful baseline data for future research on quality measures and outcomes.",
keywords = "ambulatory, tonsillectomy",
author = "Kou, {Yann Fuu} and Mitchell, {Ron B} and Johnson, {Romaine F}",
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doi = "10.1177/0194599819844791",
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AU - Johnson, Romaine F

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N2 - Objectives: To report nationwide estimates of ambulatory tonsillectomies performed in hospitals and ambulatory surgery centers in the United States. Study Design: Cross-sectional survey. Setting: National databases. Subjects and Methods: We analyzed the 2010 National Hospital Ambulatory Medical Care Survey of hospitals and ambulatory surgery centers for pediatric patients undergoing tonsillectomy with or without adenoidectomy. We determined estimations of the number of procedures, demographics, and outcomes. A tonsillectomy cohort from the 2009 National Inpatient Sample served as a comparison group. Results: In 2010, there were an estimated 339,000 (95% CI, 288,000-391,000) ambulatory tonsillectomies in the United States. The mean age was 7.8 years (SD, 5.1), and 71,000 (21.0%) were <3 years old. The male:female ratio was even (51% vs 49%). The racial makeup mirrored the US census (69% white, 18% Hispanic, and 12% black). Obstructive sleep-disordered breathing was reported in 48%. Perioperative events such as apnea, hypoxia, or bleeding occurred 7.8% of the time. Approximately 9% of patients could not be discharged home. When compared with cases of inpatient tonsillectomies, ambulatory cases comprised older patients (7.8 vs 5.9 years, P <.001) and were less likely to include obstructive sleep-disordered breathing (48% vs 77%, P <.001). Conclusion: Tonsillectomy was one of the most common ambulatory surgical procedures in 2010 in the United States. The majority of patients were low risk, but some at higher risk were included (age ≤3 years and obstructive sleep apnea). The National Hospital Ambulatory Medical Care Survey estimates provide useful baseline data for future research on quality measures and outcomes.

AB - Objectives: To report nationwide estimates of ambulatory tonsillectomies performed in hospitals and ambulatory surgery centers in the United States. Study Design: Cross-sectional survey. Setting: National databases. Subjects and Methods: We analyzed the 2010 National Hospital Ambulatory Medical Care Survey of hospitals and ambulatory surgery centers for pediatric patients undergoing tonsillectomy with or without adenoidectomy. We determined estimations of the number of procedures, demographics, and outcomes. A tonsillectomy cohort from the 2009 National Inpatient Sample served as a comparison group. Results: In 2010, there were an estimated 339,000 (95% CI, 288,000-391,000) ambulatory tonsillectomies in the United States. The mean age was 7.8 years (SD, 5.1), and 71,000 (21.0%) were <3 years old. The male:female ratio was even (51% vs 49%). The racial makeup mirrored the US census (69% white, 18% Hispanic, and 12% black). Obstructive sleep-disordered breathing was reported in 48%. Perioperative events such as apnea, hypoxia, or bleeding occurred 7.8% of the time. Approximately 9% of patients could not be discharged home. When compared with cases of inpatient tonsillectomies, ambulatory cases comprised older patients (7.8 vs 5.9 years, P <.001) and were less likely to include obstructive sleep-disordered breathing (48% vs 77%, P <.001). Conclusion: Tonsillectomy was one of the most common ambulatory surgical procedures in 2010 in the United States. The majority of patients were low risk, but some at higher risk were included (age ≤3 years and obstructive sleep apnea). The National Hospital Ambulatory Medical Care Survey estimates provide useful baseline data for future research on quality measures and outcomes.

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