Morbidity after pediatric tonsillotomy versus tonsillectomy : A population-based cohort study
© 2018 The American Laryngological, Rhinological and Otological Society, Inc..
OBJECTIVES/HYPOTHESIS: To compare and evaluate morbidity following pediatric tonsillectomy (TE) and tonsillotomy (TT) performed due to tonsil-related upper airway obstruction.
STUDY DESIGN: Retrospective population-based cohort study based on data from the Swedish National Patient Register (NPR).
METHODS: All patients aged 1 to 12 years who were registered in the NPR between January 1, 2007 and December 31, 2015, and who underwent an isolated tonsil surgery (± adenoidectomy) for the sole indication of upper airway obstruction were included. Postoperative morbidity within 30 days of surgery, including readmission due to hemorrhage and return to theater (RTT), was evaluated and compared between the two groups. A forward stepwise multivariable logistic regression analysis was used to identify independent predictors of postoperative morbidity.
RESULTS: In total, 35,060 patients were included in the study, 23,447 of whom underwent TT and 11,613 of whom underwent TE. Readmission due to postoperative hemorrhage, RTT, readmission due to any reason, and contact with healthcare were all less common after TT than after TE. Readmission due to postoperative hemorrhage was significantly more common after TE (2.5%) than after TT (0.6%) (odds ratio: 3.91, 95% confidence interval: 3.20-4.77).
CONCLUSIONS: This study showed that TT is associated with a statistically significantly lower risk of postoperative complications than TE when performed in children to correct tonsil-related upper airway obstruction. Statistically significant differences were found for all outcome variables, namely, readmission to hospital due to bleeding, RTT, readmission due to any reason, and postoperative contact with healthcare for any reason.
LEVEL OF EVIDENCE: 2b Laryngoscope, 129:2619-2626, 2019.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:129 |
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| Enthalten in: |
The Laryngoscope - 129(2019), 11 vom: 01. Nov., Seite 2619-2626 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Odhagen, Erik [VerfasserIn] |
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| Links: |
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| Themen: |
Comparative Study |
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| Anmerkungen: |
Date Completed 07.11.2019 Date Revised 08.01.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/lary.27665 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM292115466 |
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| 500 | |a Date Completed 07.11.2019 | ||
| 500 | |a Date Revised 08.01.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2018 The American Laryngological, Rhinological and Otological Society, Inc. | ||
| 520 | |a OBJECTIVES/HYPOTHESIS: To compare and evaluate morbidity following pediatric tonsillectomy (TE) and tonsillotomy (TT) performed due to tonsil-related upper airway obstruction | ||
| 520 | |a STUDY DESIGN: Retrospective population-based cohort study based on data from the Swedish National Patient Register (NPR) | ||
| 520 | |a METHODS: All patients aged 1 to 12 years who were registered in the NPR between January 1, 2007 and December 31, 2015, and who underwent an isolated tonsil surgery (± adenoidectomy) for the sole indication of upper airway obstruction were included. Postoperative morbidity within 30 days of surgery, including readmission due to hemorrhage and return to theater (RTT), was evaluated and compared between the two groups. A forward stepwise multivariable logistic regression analysis was used to identify independent predictors of postoperative morbidity | ||
| 520 | |a RESULTS: In total, 35,060 patients were included in the study, 23,447 of whom underwent TT and 11,613 of whom underwent TE. Readmission due to postoperative hemorrhage, RTT, readmission due to any reason, and contact with healthcare were all less common after TT than after TE. Readmission due to postoperative hemorrhage was significantly more common after TE (2.5%) than after TT (0.6%) (odds ratio: 3.91, 95% confidence interval: 3.20-4.77) | ||
| 520 | |a CONCLUSIONS: This study showed that TT is associated with a statistically significantly lower risk of postoperative complications than TE when performed in children to correct tonsil-related upper airway obstruction. Statistically significant differences were found for all outcome variables, namely, readmission to hospital due to bleeding, RTT, readmission due to any reason, and postoperative contact with healthcare for any reason | ||
| 520 | |a LEVEL OF EVIDENCE: 2b Laryngoscope, 129:2619-2626, 2019 | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Tonsillectomy | |
| 650 | 4 | |a postoperative morbidity | |
| 650 | 4 | |a tonsillotomy | |
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| 700 | 1 | |a Sunnergren, Ola |e verfasserin |4 aut | |
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