The Impact of Comorbid Diseases on Postoperative Complications in Children after Adenotonsillectomy: Is It a Myth?

Demir, Uygar; İnan, Hakkı Caner

doi:10.5152/tao.2020.5502

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…Therefore, addressing the challenges associated with poor oral intake and inadequate pain control is crucial for minimizing bleeding risk and optimizing patient recovery following tonsillectomy. Despite advancements in tonsillectomy techniques, the persistence of poor oral intake has been highlighted in the study conducted by Demir et al 24 Additionally, a recent local study by Alsalamah et al 14 identified poor oral intake as a contributing cause to readmission following the procedure. However, the study by Rohlfing et al 25 did not find a significant association between poor oral intake and readmission.…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictive factors of bleeding following tonsillectomy among pediatrics

Alsalamah,

Alsumairi,

Alaraifi

et al. 2024

SMJ

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Objectives: To estimate the incidence of post tonsillectomy bleeding and to identify its predisposing factors among the pediatric population. Methods: A retrospective cohort study included 1280 pediatric patients (18 years or younger) who underwent tonsillectomy at King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia between 2019 and 2020. The study sample was divided into 2 groups based on the development of postoperative bleeding and were compared using Chi-square test and independent t-test. Significant variables ( p -value ≤0.05) were included in the logistic regression model to determine the predictors of bleeding following tonsillectomy. Results: The bleeding rate following tonsillectomy was 3.4% in 43 (95% confidence interval [CI] 2.4-4.5) patients. In the multivariable logistic regression model, the significant predictors of post tonsillectomy bleeding were age ≥12 years (odds ratio [OR]: 2.685, p =0.027), decreased postoperative oral intake (OR: 4.244, p =0.042), and single use of postoperative analgesia (OR: 53.124, p <0.001). Out of the 43 patients, 39 (90.7%) patients experienced secondary bleeding, and more than half of the patients who developed bleeding required surgical intervention 27 (62.8%). Conclusion: Tonsillectomy is a safe and common surgical procedure but carries risks for postoperative bleeding. Age ≥12 years, poor postoperative oral intake, and the use of a single postoperative analgesic increase the risk of bleeding. We encourage healthcare providers to ascertain early resumption of oral intake and ensure effective pain management. We recommend a dual alternating analgesic regimen with weight-based dosing for optimal pain control. Furthermore, educating caregivers about the importance of adequate oral intake following tonsillectomy may improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Incidence and predictive factors of bleeding following tonsillectomy among pediatrics

Alsalamah,

Alsumairi,

Alaraifi

et al. 2024

SMJ

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“…However, OAHI parameters were not used in their study. 18 While there is no consensus as to whether each comorbidity alone contributes to postoperative risk, there may be an uninvestigated interplay between presence of comorbidity and very severe OSAS that may be more useful in predicting postoperative complications. Although our prior study did not show an association between OSAS severity and cardiopulmonary abnormalities, other comorbidities in patients with very severe OSAS, such as failure to thrive, trisomy 21, craniofacial abnormalities, pulmonary hypertension, and neuromuscular disease, have not yet been closely investigated.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Postoperative Outcomes for Severe and Very Severe Obstructive Sleep Apnea Syndrome

Hurly,

Clements,

Ryan

et al. 2024

The Laryngoscope

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ObjectiveTo determine if increasing obstructive sleep apnea syndrome (OSAS) severity, as determined by preoperative polysomnography data, is an independent risk for respiratory complications and level of follow‐up care after adenotonsillectomy or tonsillectomy.MethodsA retrospective analysis of patients ≤21 years of age with severe OSAS (obstructive apnea–hypopnea index [OAHI] >10) undergoing adenotonsillectomy or tonsillectomy. Patients were categorized based on preoperative polysomnography data (PSG). Outcome measures including respiratory complications were collected via chart review. Logistic regression was used in the analysis of all parameters, and Wilcoxon Rank Sum tests were used for analysis of both OAHI and oxygen saturation nadir as continuous variables. All surgeries were performed at Johns Hopkins Hospital, a tertiary care center.ResultsWe identified 358 patients with severe OSAS who had adenotonsillectomy or tonsillectomy. OAHI >40 and oxygen saturation nadir <80% were significantly associated with postoperative respiratory complications. Increasing OAHI and O2 saturation <80% was each associated with unplanned continuous positive airway pressure (CPAP) initiations postoperatively. There was no association between hypercarbia and presence of any complications.ConclusionPatients with very severe OSAS (preoperative OAHI ≥40) as determined by preoperative PSG may be at higher risk of developing respiratory complications postoperatively. However, there does not appear to be a linear association with increasing severity of OAHI on regression analysis. Further research is needed to understand factors associated with complications in severe and very severe OAHI.Level of Evidence4 Laryngoscope, 2024

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Utility of the finance-electronic medical record digital dashboard in pediatric otolaryngology

Shirley

Anne

et al. 2022

American Journal of Otolaryngology

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The Impact of Comorbid Diseases on Postoperative Complications in Children after Adenotonsillectomy: Is It a Myth?

Abstract: Owner and Responsible Manager on behalf of the Turkish Otorhinolaryngology Head and Neck Surgery Society / Türk Kulak Burun Boğaz ve Baş Boyun Cerrahisi Derneği adına Sahibi ve Sorumlu Yazı İşleri Müdürü: Özgür YİĞİT •

Cited by 4 publications

References 27 publications

Incidence and predictive factors of bleeding following tonsillectomy among pediatrics

Incidence and predictive factors of bleeding following tonsillectomy among pediatrics

Pediatric Postoperative Outcomes for Severe and Very Severe Obstructive Sleep Apnea Syndrome

Utility of the finance-electronic medical record digital dashboard in pediatric otolaryngology

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