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Tonsillectomy care processes vary among US hospitals; revision may be necessary
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Routine tonsillectomy care processes and outcomes vary significantly among hospitals in the United States, according to recent study findings published in Pediatrics.
The retrospective cohort study included children aged 1 to 18 years who underwent same-day tonsillectomy between 2004 and 2010 at 36 US hospitals. Researchers assessed revisits that occurred up to 30 days after the procedure.
Of the 139,715 study participants, 69.6% received dexamethasone and 31.1% received antibiotics on the day of surgery. Among hospitals, the median percentage of patients that received dexamethasone was higher than the percentage that received antibiotics (76.2% vs. 16.3%).
Regarding revisits, 7.8% (n=10,868) of children revisited the hospital within 30 days after surgery. Three percent (n=4,182) of children revisited due to bleeding and 2.2% (n=3,011) revisited because of vomiting and dehydration. Most revisits occurred within 15 days after surgery.
Researchers found that patients aged 10 to 18 years were more likely to revisit for bleeding compared with younger (aged 1 to 3 years) patients in the study. Additionally, older patients aged 10 to 18 years were less likely to revisit for vomiting and dehydration.
The study findings did not show a significant correlation between risk for revisits and use of dexamethasone or antibiotics.
“Our study shows that variation in care processes and outcomes continues today. Quality improvement initiatives are needed to implement current evidence into practice, understand and disseminate the practices of high-performing hospitals, and improve the value of health care delivered for children undergoing tonsillectomy,” study researcher Sanjay Mahant, FRCPC, MSc, of the University of Toronto, and colleagues concluded.
Disclosure: Six researchers have a financial relationship with the Children’s Hospital Association. See the study for a full list of researchers’ financial disclosures.
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