Premium
Postoperative respiratory complications and racial disparities following inpatient pediatric tonsillectomy: A cross‐sectional study
Author(s) -
Kou YannFuu,
Sakai Mark,
Shah Gopi B.,
Mitchell Ron B.,
Johnson Romaine F.
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27405
Subject(s) - medicine , tonsillectomy , odds ratio , asthma , confidence interval , poisson regression , psychological intervention , obstructive sleep apnea , adenoidectomy , pediatrics , surgery , population , environmental health , psychiatry
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[2][Morris LG, 2008] 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