Out-Patient Tonsillectomy in Children

Mar 17, 2018
Is it Safe for Children Younger than Three to Have Their Tonsils Removed as an Outpatient?

Bottom Line: Healthy children younger than 3 were more likely to have a complication after having their tonsils removed than older children.

Why The Research Is Interesting: Tonsillectomy is the second most common surgery performed for children in the United States, with more than 530,000 procedures performed each year.

Who and When: Medical record review for 1,817 children ages 3 to 6 who underwent tonsillectomy between 2005 and 2015.

What (Study Measures): Age and weight of the child at the time of tonsillectomy (exposure); complications including respiratory distress, dehydration requiring intravenous fluids and bleeding (outcomes).

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Claire M. Lawlor, M.D., Boston Children’s Hospital, Boston, and co-authors

Results:
Please see image here: https://8zdwfheqf626okso1umzsoo3-wpengine.netdna-ssl.com/wp-content/uploads/2018/03/03-15-OTO-tonsils-graph.png

Study Limitation: The researchers cannot account for missing data from patients with complications who did not present to the ambulatory clinics or emergency departments of the hospitals in the study.

Study Conclusions:

Children younger than 3 years may benefit from 23-hour observation after tonsillectomy; clinician judgement is crucial in determining which patients are safe for outpatient tonsillectomy.

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jamaoto.2017.3431)