Evaluation of day-care tonsil surgery in young children

• Published in: Danish medical journal Vol. 66; no. 3
• Main Authors: Bruaset, Andrea M, Dahlstrøm, Michael, Möller, Sören, Kjeldsen, Anette Drøhse
• Format: Journal Article
• Language: English
• Published: Denmark 01.03.2019
• Subjects: Adolescent; Age Factors; Child; Child, Preschool; Day Care, Medical; Denmark; Female; Humans; Logistic Models; Male; Multivariate Analysis; Pain - epidemiology; Palatine Tonsil - surgery; Patient Readmission - statistics & numerical data; Postoperative Complications - epidemiology; Postoperative Hemorrhage - epidemiology; Retrospective Studies; Tonsillectomy - adverse effects; Denmark
• ISSN: 2245-1919

The National Clinical Guideline for Ton-sillectomy (Danish Health Authority, 2016) suggests inpatient admission after elective tonsil surgery in patients aged < 4 years at the time of surgery. We aimed to evaluate the safety of tonsil surgery as day surgery in children ≤ 4 years of age. The charts of 414 patients aged 2-15 years who underwent elective tonsillectomy, adenotonsillectomy or tonsillotomy at Svendborg Hospital, Denmark, from February 2010 to April 2015 were reviewed in a retrospective cohort. We investigated post-operative complications, defined as post-operative haemorrhage and unplanned contacts or revisits to the hospital. A total of 389 patients were divided into two groups by age (≤ 4/> 4 years). In all, 108 patients contacted or revisited the hospital after discharge. Patients aged ≤ 4 years accounted for the majority of contacts unrelated to bleeding and associated with complaints of pain and pain medication. Haemorrhage occurred in 22 (5.7%) patients, 19 of whom were > 4 years. The rates of haemorrhage, readmission and secondary surgery were significantly higher in patients aged > 4 years than in the remaining patients. Patients ≤ 4 years experienced significantly less haemorrhage but had more unplanned contacts than patients > 4 years. For reassurance of caretakers, easy access to telephone contact with hospital staff in the post-operative period is important. none. not relevant.