Educational Objective: At the conclusion of this presentation, the participants should be able to understand differences in management of pediatric patients undergoing adenoidectomy with and without concomitant tonsillectomy in the context of a database study.
Objectives: Adenoidectomy is a common procedure that is often performed in conjunction with a tonsillectomy. This study investigates differences in between pediatric patients undergoing adenoidectomy alone and with concomitant tonsillectomy (T&A). Study Design: Retrospective database review.
Methods: The 2016 Kid's Inpatient Database was used to identify pediatric patients undergoing adenoidectomy by external approach (ICD-10-PCS: 0CTQXZZ) with and without tonsillectomy (ICD-10: 0CTP, 0CBP). Postoperative respiratory complications were identified via ICD-10 codes. Univariate and multivariable analyses were performed to determine statistical associations.
Results: Of the 4,000 identified patients undergoing adenoidectomy, 442 did not undergo tonsillectomy. Those who underwent adenoidectomy alone were younger than those who underwent T&A (mean 3.5 vs. 5.1 years, p<0.001) and more likely to be White (44.9% vs. 37.6%, p=0.002). Upon multivariable analysis, those who underwent adenoidectomy alone had similar costs to those with T&A ($48,978 vs. $35,388, p=0.426). Patients who underwent adenoidectomy alone had longer length of stays (LOS) (4.0 vs. 2.5 days, p=0.009) and were more likely to undergo bronchoscopy (OR 1.51, 95% 1.04-2.19, p=0.030). There was no significant difference in risks for postoperative respiratory complications between those who underwent adenoidectomy alone and with T&A (OR 0.94, 95% CI 0.60-1.47, p=0.781).
Conclusions: Adenoidectomy is frequently performed in conjunction with tonsillectomy in pediatric patients. Those who underwent adenoidectomy alone had longer LOS and were more likely to undergo bronchoscopy, but had similar risk for respiratory complications compared to those who underwent T&A.