Postop T&A complications in ASC vs inpatient settings

Editor's Note

Large numbers of pediatric patients have tonsillectomies and adenoidectomies (T&As) in ambulatory surgery centers (ASCs) despite higher rates of complications in younger patients and patients with more comorbidities, this study finds.

In this retrospective review, researchers from Stanford University, Stanford, California, analyzed 115,214 children having T&As in hospitals, hospital-based facilities, and freestanding facilities.

T&A was associated with increased risk for all complication types in ASC and inpatient settings, reaching an odds ratio of 8.5 for respiratory complications in ASCs.

Inpatients aged 0 to 9 years had higher rates of airway and respiratory complications, peaking at an odds ratio of 7.5 for airway complications in those aged 0 to 11 months.

Importance A large-scale review is needed to characterize the rates of airway, respiratory, and cardiovascular complications after pediatric tonsillectomy and adenoidectomy (T&A) for inpatient and ambulatory cohorts. Objective To identify risk factors for postoperative complications stratified by age and operative facility type among children undergoing T&A.