A Cross‐sectional Analysis of Pediatric Ambulatory Tonsillectomy Surgery in the United States

Abstract

Objectives To report nationwide estimates of ambulatory tonsillectomies performed in hospitals and ambulatory surgery centers in the United States. Study Design Cross-sectional survey. Setting National databases. Subjects and Methods We analyzed the 2010 National Hospital Ambulatory Medical Care Survey of hospitals and ambulatory surgery centers for pediatric patients undergoing tonsillectomy with or without adenoidectomy. We determined estimations of the number of procedures, demographics, and outcomes. A tonsillectomy cohort from the 2009 National Inpatient Sample served as a comparison group. Results In 2010, there were an estimated 339,000 (95% CI, 288,000-391,000) ambulatory tonsillectomies in the United States. The mean age was 7.8 years (SD, 5.1), and 71,000 (21.0%) were <3 years old. The male:female ratio was even (51% vs 49%). The racial makeup mirrored the US census (69% white, 18% Hispanic, and 12% black). Obstructive sleep-disordered breathing was reported in 48%. Perioperative events such as apnea, hypoxia, or bleeding occurred 7.8% of the time. Approximately 9% of patients could not be discharged home. When compared with cases of inpatient tonsillectomies, ambulatory cases comprised older patients (7.8 vs 5.9 years, P < .001) and were less likely to include obstructive sleep-disordered breathing (48% vs 77%, P < .001). Conclusion Tonsillectomy was one of the most common ambulatory surgical procedures in 2010 in the United States. The majority of patients were low risk, but some at higher risk were included (age ≤3 years and obstructive sleep apnea). The National Hospital Ambulatory Medical Care Survey estimates provide useful baseline data for future research on quality measures and outcomes.

Establishment of resilience in a challenging recovery at home after pediatric tonsil surgery—Children’s and caregivers’ perspectives

“…Tonsil surgery is often performed in outpatient settings, 13 meaning that the hospitalization is short and most of the recovery takes place at home. This puts significant demands on families to manage varied conditions 14,15 .…”

Reduction in Pediatric Ambulatory Adenotonsillectomy Length of Stay Using Clinical Care Guidelines

“…Adenotonsillectomy (T&A) has been well established as a safe ambulatory procedure in the low-risk pediatric patient over 3 years of age. [1][2][3][4] Historically, as surgeons transitioned to performing T&A on an outpatient basis, initial practice often suggested a 4-hour postsurgery observation period to assess for hemostasis, respiratory stability, pain control, and oral intake. 5,6 Competing literature, however, has demonstrated the safety and feasibility of shorter observation periods, allowing for improved patient throughput.…”

Day Surgery Conversion: Rate and Possible Causes in King Fahad Specialist Hospital, Buraydah, Saudi Arabia

“…Day surgery is becoming increasingly popular as estimated by the National Health Statistics Reports of the United States of America in 2017, with multiple types of procedures being done as ambulatory [ 3 ]. In 2010, for instance, tonsillectomy with or without adenoidectomy, which is one of the commonest procedures in children, has been estimated to be done 339.000 times across the United States (US) [ 4 ].…”