TY - JOUR
T1 - Postoperative respiratory complications and racial disparities following inpatient pediatric tonsillectomy
T2 - A cross-sectional study
AU - Kou, Yann Fuu
AU - Sakai, Mark
AU - Shah, Gopi
AU - Mitchell, Ron B
AU - Johnson, Romaine F
N1 - Publisher Copyright:
© 2018 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2019/4
Y1 - 2019/4
N2 - Objectives/Hypothesis: To study rates of respiratory complications/interventions among inpatient tonsillectomy patients in the United States and identify risk factors for these events. Study Design: Retrospective database review. Methods: Children (age < 18 years) undergoing tonsillectomy with or without adenoidectomy in 2006, 2009, and 2012 were studied using the Kids Inpatient Database, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Outcomes were analyzed for respiratory events (complications/interventions) and racial disparities. Pearson χ test was used to analyze categorical data and regression analysis was used for continuous variables. Respiratory events were analyzed by racial identity using logistic regression analysis. A P <.05 was considered significant. Results: The study included 30,617 patients (41% female, 51% white, 24% African American, 23% Hispanic, 3.0% Asian). The mean age was 5.2 years, and mean length of stay 2.3 days. The overall complication rate was 6.0%, and overall intervention rate was 3.6%. Respiratory events were more common among African American children (odds ratio [OR]: 1.5, 95% confidence interval [CI]: 1.3-1.6) and less common among white children (OR: 0.8, 95% CI: 0.8-0.9). These differences were significant after controlling for age, gender, obesity, obstructive sleep apnea, and asthma. The mortality rate was 0.05% with no ethnic predilection. Conclusions: Respiratory events after inpatient tonsillectomy included laryngo/bronchospasm, pneumonia, pulmonary edema, intubation, prolonged intubation, and ventilation. Although uncommon, these were more common among African American children. Further research is needed to understand the etiology of this disparity. Level of Evidence: NA Laryngoscope, 129:995–1000, 2019.
AB - Objectives/Hypothesis: To study rates of respiratory complications/interventions among inpatient tonsillectomy patients in the United States and identify risk factors for these events. Study Design: Retrospective database review. Methods: Children (age < 18 years) undergoing tonsillectomy with or without adenoidectomy in 2006, 2009, and 2012 were studied using the Kids Inpatient Database, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Outcomes were analyzed for respiratory events (complications/interventions) and racial disparities. Pearson χ test was used to analyze categorical data and regression analysis was used for continuous variables. Respiratory events were analyzed by racial identity using logistic regression analysis. A P <.05 was considered significant. Results: The study included 30,617 patients (41% female, 51% white, 24% African American, 23% Hispanic, 3.0% Asian). The mean age was 5.2 years, and mean length of stay 2.3 days. The overall complication rate was 6.0%, and overall intervention rate was 3.6%. Respiratory events were more common among African American children (odds ratio [OR]: 1.5, 95% confidence interval [CI]: 1.3-1.6) and less common among white children (OR: 0.8, 95% CI: 0.8-0.9). These differences were significant after controlling for age, gender, obesity, obstructive sleep apnea, and asthma. The mortality rate was 0.05% with no ethnic predilection. Conclusions: Respiratory events after inpatient tonsillectomy included laryngo/bronchospasm, pneumonia, pulmonary edema, intubation, prolonged intubation, and ventilation. Although uncommon, these were more common among African American children. Further research is needed to understand the etiology of this disparity. Level of Evidence: NA Laryngoscope, 129:995–1000, 2019.
KW - Tonsillectomy
KW - healthcare disparities
KW - respiratory complications
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U2 - 10.1002/lary.27405
DO - 10.1002/lary.27405
M3 - Review article
C2 - 30412279
AN - SCOPUS:85056304758
SN - 0023-852X
VL - 129
SP - 995
EP - 1000
JO - Laryngoscope
JF - Laryngoscope
IS - 4
ER -