Outcomes of a Postoperative Data-Extraction Questionnaire After Adenotonsillectomy in Children

Laryngoscope. 2021 Nov;131(11):E2821-E2826. doi: 10.1002/lary.29626. Epub 2021 May 20.

Abstract

Objectives/hypothesis: To evaluate outcomes of a postoperative telephone questionnaire for children who underwent adenotonsillectomy (T&A). To determine whether episodes of postoperative hemorrhage were not captured until the call, and whether this impacted knowledge of physician rates of hemorrhage.

Study design: Retrospective database analysis.

Methods: Retrospective analysis of outcomes of an 11-question data extraction tool utilized at a tertiary care children's hospital for follow-up in T&A patients <18 years of age over a 2-year period. Sub-analysis of positive responses to the question asking about incidence of postoperative hemorrhage.

Results: During the study period, 1,068/3,142 (34.0%) parents responded to the phone call. Median age was 6.0 years (interquartile range [IQR] 4.0-8.2), and 566 (53.0%) were male. Ninety (8.4%) noted that the child was still snoring, but only 9 (0.84%) reported signs of obstructed breathing. A total of 402 (37.6%) reported a voice change after surgery. Most children (n = 885, 82.9%) did not receive opioid analgesics, and 252 (23.6%) received acetaminophen/ibuprofen 7 days postoperatively. Return visits to the emergency department were reported in 149 patients; primarily for hemorrhage in 46 (30.8%). In 7 (15.2%) patients, the hemorrhage event was not recorded until the call. The majority-of respondents (n = 1,031, 96.5%) were satisfied with the outcome of the procedure.

Conclusions: The postoperative T&A tool provided a means of gathering information on success and satisfaction with surgical outcomes. Children were able to be managed primarily with acetaminophen and ibuprofen. Most complications were captured in the electronic record, although some episodes of hemorrhage were not noted until the call, emphasizing the importance of follow-up.

Level of evidence: 3 Laryngoscope, 131:E2821-E2826, 2021.

Keywords: Pediatric adenotonsillectomy; adenotonsillectomy complications; postoperative outcomes; tonsillectomy hemorrhage.

MeSH terms

  • Acetaminophen / standards
  • Acetaminophen / therapeutic use
  • Adenoidectomy / adverse effects*
  • Analgesics, Non-Narcotic / standards
  • Analgesics, Non-Narcotic / therapeutic use
  • Case-Control Studies
  • Child
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Ibuprofen / standards
  • Ibuprofen / therapeutic use
  • Incidence
  • Male
  • Outcome Assessment, Health Care
  • Postoperative Hemorrhage / diagnosis
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology*
  • Postoperative Period
  • Retrospective Studies
  • Surveys and Questionnaires / standards*
  • Surveys and Questionnaires / statistics & numerical data
  • Tertiary Care Centers
  • Tonsillectomy / adverse effects*

Substances

  • Analgesics, Non-Narcotic
  • Acetaminophen
  • Ibuprofen