loading page

How do we safely increase day-case tonsillectomy for the treatment of paediatric obstructive sleep apnoea -- a cohort analysis
  • +6
  • Chang Woo Lee,
  • Ashleigh Ivy,
  • Brittany Brownlee,
  • Mohammed Bahgat,
  • Aoife Waters,
  • Lakhbinder Pabla,
  • Claire Mclarnon,
  • Gerard Siou,
  • Steven Powell
Chang Woo Lee
Great North Children's Hospital

Corresponding Author:[email protected]

Author Profile
Ashleigh Ivy
Great North Children's Hospital
Author Profile
Brittany Brownlee
Great North Children's Hospital
Author Profile
Mohammed Bahgat
Great North Children's Hospital
Author Profile
Aoife Waters
Great North Children's Hospital
Author Profile
Lakhbinder Pabla
Great North Children's Hospital
Author Profile
Claire Mclarnon
Great North Children's Hospital
Author Profile
Gerard Siou
Great North Children's Hospital
Author Profile
Steven Powell
Great North Children's Hospital
Author Profile

Abstract

Background: There is an increasing importance to increasing the day-case rate for children undergoing adenotonsillectomy. The primary aim of this study was to evaluate the immediate post-operative complication (IPOC) rate of children undergoing adenotonsillectomy for the treatment of paediatric obstructive sleep apnoea (OSA), with a view to increasing the day-case rate. IPOC was defined as any adverse clinical events experienced if admitted, or as a re-presentation to the emergency department/ward if done as a day-case, within 24 hours of the surgery. The secondary aim was to evaluate the risk factors predictive of IPOC. Methods: A retrospective analysis of children undergoing adenotonsillectomy for OSA between 01/11/2019–31/03/2022. Results: 464 children were included. Children done as a day-case experienced 0% IPOC (n=260; 220 were planned day-case). Children done as an inpatient experienced 16.7% IPOC (n=34/204). Every child who experienced IPOC had one or more of the following four clinical features: age <3 years, <15 kg, >98th weight centile, significant medical comorbidities. 269 children had none of these four clinical features, and experienced 0.371% IPOC (n=1/269; primary post-tonsillectomy bleed). Children with pre-operative oximetry scores of McGill 3-4 experienced 0% IPOC if they had none of the four clinical features (n=20). The overall readmission rate was 2.80% (n=13/464). Conclusion: Our experience suggests children with none of the four clinical risk factors identified can have adenotonsillectomy performed as a day-case procedure, irrespective of the pre-operative oximetry results. Pre-operative oximetry does not appear to add any additional value in predicting adverse post-operative events.
23 Jan 2023Submitted to Clinical Otolaryngology
25 Jan 2023Submission Checks Completed
25 Jan 2023Assigned to Editor
03 Feb 2023Reviewer(s) Assigned
09 Aug 2023Review(s) Completed, Editorial Evaluation Pending
20 Aug 2023Editorial Decision: Revise Minor
18 Sep 20231st Revision Received
19 Sep 2023Submission Checks Completed
19 Sep 2023Assigned to Editor
20 Sep 2023Reviewer(s) Assigned
02 Oct 2023Review(s) Completed, Editorial Evaluation Pending
14 Oct 2023Editorial Decision: Revise Minor
29 Oct 20232nd Revision Received
30 Oct 2023Assigned to Editor
30 Oct 2023Submission Checks Completed