TY - JOUR
T1 - Pediatric adenotonsillectomy and postoperative hemorrhage
T2 - Demographic and geographic variation in the US
AU - Harounian, Jonathan A.
AU - Schaefer, Eric
AU - Schubart, Jane
AU - Carr, Michele M.
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Objective: To examine demographic and regional variations in pediatric tonsillectomy, with or without adenoidectomy, and post-tonsillectomy hemorrhage on a national level. Methods: The MarketScan® database was analyzed for claims made between 2008-2012 for the 30 days following tonsillectomy/adenotonsillectomy in privately insured children 1-17 years of age. Results: We analyzed 305,860 patients with 98.6% of these tonsillectomies occurring in an ambulatory setting. Children between 3-6 years old comprised our largest group of tonsillectomies (45.1%). More tonsillectomies were done in the South (42.1%) than any other region in our sample. Patients between 11 and17 years old had the highest percentage of bleeding (4.8%). Patients between 1 and 3 years old had the lowest values. Of the 8,518 children who presented with post-operative hemorrhage, 71.7% had only one hemorrhagic event, 28.3% had at least a second one, 6.0% had at least 3 events, and 1.3% had at least 4 events. Post-operative dehydration had a similar pattern. The South had the lowest percentage of post-tonsillectomy bleeds (2.5%) and overall ER visits (7.1%), both of which were most common in the Midwest. Gender had no significant association with incidence of tonsillectomy procedures or post-op complications. Conclusion: There are geographic and demographic variations in adenotonsillectomy and in post-operative complications for children nationally.
AB - Objective: To examine demographic and regional variations in pediatric tonsillectomy, with or without adenoidectomy, and post-tonsillectomy hemorrhage on a national level. Methods: The MarketScan® database was analyzed for claims made between 2008-2012 for the 30 days following tonsillectomy/adenotonsillectomy in privately insured children 1-17 years of age. Results: We analyzed 305,860 patients with 98.6% of these tonsillectomies occurring in an ambulatory setting. Children between 3-6 years old comprised our largest group of tonsillectomies (45.1%). More tonsillectomies were done in the South (42.1%) than any other region in our sample. Patients between 11 and17 years old had the highest percentage of bleeding (4.8%). Patients between 1 and 3 years old had the lowest values. Of the 8,518 children who presented with post-operative hemorrhage, 71.7% had only one hemorrhagic event, 28.3% had at least a second one, 6.0% had at least 3 events, and 1.3% had at least 4 events. Post-operative dehydration had a similar pattern. The South had the lowest percentage of post-tonsillectomy bleeds (2.5%) and overall ER visits (7.1%), both of which were most common in the Midwest. Gender had no significant association with incidence of tonsillectomy procedures or post-op complications. Conclusion: There are geographic and demographic variations in adenotonsillectomy and in post-operative complications for children nationally.
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U2 - 10.1016/j.ijporl.2016.05.018
DO - 10.1016/j.ijporl.2016.05.018
M3 - Article
C2 - 27368442
AN - SCOPUS:84971254706
SN - 0165-5876
VL - 87
SP - 50
EP - 54
JO - International Journal of Pediatric Otorhinolaryngology
JF - International Journal of Pediatric Otorhinolaryngology
ER -