TY - JOUR
T1 - Post-Tonsillectomy Outcomes in Children With and Without Narcotics Prescriptions
AU - Carr, Michele M.
AU - Schaefer, Eric W.
AU - Schubart, Jane R.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a grant from the HG Barsumian MD Memorial Fund.
Publisher Copyright:
© The Author(s) 2019.
PY - 2021/2
Y1 - 2021/2
N2 - Objective: To examine differences in outcomes after tonsillectomy in children who received outpatient narcotics prescriptions compared to those who did not. Methods: The MarketScan database was analyzed for claims made for 14 days following tonsillectomy/adenotonsillectomy between 2008 and 2012 for privately insured children 1 to 17 years. Post-op bleeding, dehydration, emergency department (ED) visits, readmissions, and mean total costs for the 14 days after tonsillectomy were compared. Results: Of the 294 795 patients included, 60.9% received a narcotic prescription. Acetaminophen/hydrocodone bitartrate was received by 53.2% of the group receiving narcotic drugs, 42.5% received acetaminophen/codeine phosphate, 3.0% received acetaminophen/oxycodone hydrochloride, and 0.5% received oxycodone hydrochloride alone. Children who had been prescribed narcotics had significantly higher percentages of bleeding complications (2.7% vs 2.5%, P <.001), and ED visits (6.8% vs 6.6%, P <.001) within 14 days, but a lower percentage of readmissions (1.0% vs 1.5%, P <.001). No significant difference was observed between groups for dehydration. There were some age-related differences. The mean total health-care costs for 14 days post-op were the same in each group, except for the 4- to 6-year-olds, where the narcotic group had higher costs (US $7060 vs US $5840, P =.006). Conclusion: In this large-scale study, we found small but statistically significant differences in outcomes related to use of narcotics. The only outcome that benefitted the narcotics group was a lower readmission rate.
AB - Objective: To examine differences in outcomes after tonsillectomy in children who received outpatient narcotics prescriptions compared to those who did not. Methods: The MarketScan database was analyzed for claims made for 14 days following tonsillectomy/adenotonsillectomy between 2008 and 2012 for privately insured children 1 to 17 years. Post-op bleeding, dehydration, emergency department (ED) visits, readmissions, and mean total costs for the 14 days after tonsillectomy were compared. Results: Of the 294 795 patients included, 60.9% received a narcotic prescription. Acetaminophen/hydrocodone bitartrate was received by 53.2% of the group receiving narcotic drugs, 42.5% received acetaminophen/codeine phosphate, 3.0% received acetaminophen/oxycodone hydrochloride, and 0.5% received oxycodone hydrochloride alone. Children who had been prescribed narcotics had significantly higher percentages of bleeding complications (2.7% vs 2.5%, P <.001), and ED visits (6.8% vs 6.6%, P <.001) within 14 days, but a lower percentage of readmissions (1.0% vs 1.5%, P <.001). No significant difference was observed between groups for dehydration. There were some age-related differences. The mean total health-care costs for 14 days post-op were the same in each group, except for the 4- to 6-year-olds, where the narcotic group had higher costs (US $7060 vs US $5840, P =.006). Conclusion: In this large-scale study, we found small but statistically significant differences in outcomes related to use of narcotics. The only outcome that benefitted the narcotics group was a lower readmission rate.
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U2 - 10.1177/0145561319859303
DO - 10.1177/0145561319859303
M3 - Article
C2 - 31304781
AN - SCOPUS:85069887327
SN - 0145-5613
VL - 100
SP - 124
EP - 129
JO - Ear, Nose and Throat Journal
JF - Ear, Nose and Throat Journal
IS - 2
ER -