TY - JOUR
T1 - Reflux as a Risk Factor for Morbidity after Pediatric Tonsillectomy
T2 - A National Cohort of Inpatients
AU - Chorney, Stephen R.
AU - Zur, Karen B.
AU - Buzi, Adva
N1 - Publisher Copyright:
© 2020 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2021/4
Y1 - 2021/4
N2 - Objective: Gastroesophageal reflux (GER) has been identified as a risk factor for complications following pediatric tonsillectomy. The primary objective of this study was to examine outcomes after tonsillectomy among children with GER using a nationwide database. Secondary objectives included analyzing duration of hospitalization and total charges after admission. Methods: A cross-sectional review of the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Databases (KID) from 2012 and 2016. Results: A total of 21,232 children had a tonsillectomy with or without adenoidectomy, with 1683 (7.9%) diagnosed with GER. Average age for patients with reflux was 4.4 years and for those without was 5.6 years (P <.001). The rate of primary hemorrhage was not statistically different between groups (P =.87). Patients with reflux were more likely to have respiratory complications (P =.03), aspiration pneumonitis (P <.001), and hypoxemia (P <.001) during their hospital course. Noninvasive ventilation and reintubation also occurred more frequently in this population (P <.001). Children with reflux had a longer duration of postoperative admission (3.8 vs. 2.3 days, P <.001) and higher total hospital charges ($47,129 vs. $27,584, P <.001). Multivariable regression analysis determined that reflux remained a statistically significant indicator of aspiration pneumonitis, hypoxemia, invasive and non-invasive ventilation, as well as length of admission. Conclusion: Children with GER were significantly more likely to experience inpatient complications following tonsillectomy. Further, length of admission was higher compared to children without reflux. These results suggest that children with GER experience poorer outcomes after tonsillectomy and highlight the role for appropriate preoperative counseling and planning in this patient population. Laryngoscope, 131:907–910, 2021.
AB - Objective: Gastroesophageal reflux (GER) has been identified as a risk factor for complications following pediatric tonsillectomy. The primary objective of this study was to examine outcomes after tonsillectomy among children with GER using a nationwide database. Secondary objectives included analyzing duration of hospitalization and total charges after admission. Methods: A cross-sectional review of the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Databases (KID) from 2012 and 2016. Results: A total of 21,232 children had a tonsillectomy with or without adenoidectomy, with 1683 (7.9%) diagnosed with GER. Average age for patients with reflux was 4.4 years and for those without was 5.6 years (P <.001). The rate of primary hemorrhage was not statistically different between groups (P =.87). Patients with reflux were more likely to have respiratory complications (P =.03), aspiration pneumonitis (P <.001), and hypoxemia (P <.001) during their hospital course. Noninvasive ventilation and reintubation also occurred more frequently in this population (P <.001). Children with reflux had a longer duration of postoperative admission (3.8 vs. 2.3 days, P <.001) and higher total hospital charges ($47,129 vs. $27,584, P <.001). Multivariable regression analysis determined that reflux remained a statistically significant indicator of aspiration pneumonitis, hypoxemia, invasive and non-invasive ventilation, as well as length of admission. Conclusion: Children with GER were significantly more likely to experience inpatient complications following tonsillectomy. Further, length of admission was higher compared to children without reflux. These results suggest that children with GER experience poorer outcomes after tonsillectomy and highlight the role for appropriate preoperative counseling and planning in this patient population. Laryngoscope, 131:907–910, 2021.
KW - Gastroesophageal reflux, hospital admission, morbidity, pediatrics, respiratory complications, tonsillectomy
UR - http://www.scopus.com/inward/record.url?scp=85088093669&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088093669&partnerID=8YFLogxK
U2 - 10.1002/lary.28895
DO - 10.1002/lary.28895
M3 - Article
C2 - 32681749
AN - SCOPUS:85088093669
SN - 0023-852X
VL - 131
SP - 907
EP - 910
JO - Laryngoscope
JF - Laryngoscope
IS - 4
ER -