Original Report

Reflux as a Risk Factor for Morbidity after Pediatric Tonsillectomy: A National Cohort of Inpatients

Corresponding Author

Stephen R. Chorney MD, MPH

[email protected]

orcid.org/0000-0003-1419-6019

Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Send correspondence to Stephen R. Chorney, MD, MPH, and Adva Buzi, MD, Division of Otolaryngology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., 1 Wood ENT, Philadelphia, PA 19104. E-mail: [email protected]; [email protected]Search for more papers by this author

Karen B. Zur MD,

Karen B. Zur MD

orcid.org/0000-0002-9045-6559

Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Search for more papers by this author

Adva Buzi MD,

Adva Buzi MD

[email protected]

Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Search for more papers by this author

Stephen R. Chorney MD, MPH,

Corresponding Author

Stephen R. Chorney MD, MPH

[email protected]

orcid.org/0000-0003-1419-6019

Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Karen B. Zur MD,

Karen B. Zur MD

orcid.org/0000-0002-9045-6559

Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Search for more papers by this author

Adva Buzi MD,

Adva Buzi MD

[email protected]

Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Search for more papers by this author

First published: 18 July 2020

https://doi.org/10.1002/lary.28895

Citations: 3

Editor's Note: This Manuscript was accepted for publication on June 11, 2020.

Meeting information: Presented as a virtual podium presentation at the 2020 American Broncho-Esophagological Association Annual Meeting, April 24, 2020.

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Abstract

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

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Citing Literature

Volume131, Issue4

April 2021

Pages 907-910

Reflux as a Risk Factor for Morbidity after Pediatric Tonsillectomy: A National Cohort of Inpatients

Abstract

Objective

Methods

Results

Conclusion

BIBLIOGRAPHY

Citing Literature

References

Information

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Reflux as a Risk Factor for Morbidity after Pediatric Tonsillectomy: A National Cohort of Inpatients

Abstract

Objective

Methods

Results

Conclusion

BIBLIOGRAPHY

Citing Literature

References

Related

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