ASPO042 - Predictive Factors for Prolonged Length of Stay After Tonsillectomy in Pediatric Patients
Saturday, April 30, 2022
4:00 PM – 4:55 PM CT
Location: Landmark C
Karandeep S. Randhawa, BS1, Avneet Randhawa, BS1, Prayag Patel, MD1, Christina H. Fang, MD2, Jean A. Eloy, MD, FACS1
1Department of Otolarygology - Head and Neck Surgery, New Jersey Med. Sch., Newark, NJ, 2Department of Otorhinolaryngology - Head and Neck Surgery, Albert Einstein Coll. of Med., Bronx, NY.
Introduction: Tonsillectomy is one of the most commonly performed pediatric procedures. Although some previous studies have analyzed postoperative outcomes of tonsillectomies and others have analyzed techniques and approaches, very few have looked specifically into factors associated with length of stay postoperatively. Therefore, this study aimed to analyze prognostic factors associated with prolonged length of stay after inpatient pediatric tonsillectomies.
Methods: The 2003 to 2014 National Inpatient Sample database was queried for patients under 18 years old with a primary inpatient procedure of tonsillectomy. Prolonged length of stay (LOS) was indicated by values greater than the 90th percentile of the overall sample. This analysis utilized chi square, ANOVA, and binary logistic regression.
Results: 3,142 weighted cases were identified. Demographic factors associated with prolonged LOS included male sex (OR 1.134, 95% CI 1.024-1.255, p=0.016 vs. females), Black race (OR 1.566, 95% CI 1.356-1.808, p<0.001 vs. Whites), Medicaid insurance (OR 1.288, 95% CI 1.128-1.472, p<0.001 vs. private insurance), self-pay (OR 1.731, 95% CI 1.183-2.534, p=0.005), 0 to 25th income percentile (OR 1.392, 95% CI 1.160-1.671, p<0.001 vs. 76th to 100th income percentile), and 26th to 50th income percentile (OR 1.257, 95% CI 1.065-1.483, p=0.007 vs. 76th to 100th income percentile). Comorbidities associated with prolonged LOS included deficiency anemias (OR 5, 95% CI 3.584-6.993, p<0.001), pulmonary circulatory diseases (OR 4.608, 95% CI 3.058-6.944, p<0.001), paralysis (OR 3.546, 95% CI 2.777-4.504, p<0.001), congestive heart failure (OR 1.201, 95% CI 1.062-1.361, p=0.004), coagulopathy (OR 1.912 95% CI 1.349-2.702, p<0.001), and liver disease (OR 2.174 95% CI 1.241-3.817, p=0.007).
Conclusion: Multiple demographic and comorbid factors are associated with prolonged LOS in pediatric patients undergoing tonsillectomy. Specifically, factors related to lower socioeconomic status were predictors of prolonged LOS.