Predictive Factors of Prolonged Hospital Stay in Tonsillectomy Patients

Abstract

Objective: Tonsillectomy remains one of the most common surgeries performed in the pediatric population. Factors that are predictive of a prolonged stay after tonsillectomy are useful in planning postop care.

Method: A retrospective chart review was completed inclusive of all pediatric patients who had tonsillectomy at a tertiary medical center from March 10, 2010, to January 1, 2011. Preoperative variables were analyzed to determine predictors of extended hospital stay (defined as > 24 hours).

Results: A total of 210 patients were reviewed. Thirty-three patients (15.7%) had hospital stays greater than 24 hours. Indications for tonsillectomy included obstructive sleep apnea (69.5%), tonsillitis (9.5%), and asymmetry (1.9%). Twenty-eight (84.8%) patients had extended stays for poor oral intake. Fever and respiratory complications accounted for 0.06% respectively. Patients with extended stays were younger (P < .001), weighed less (P < .001), and had higher apnea-hypopnea indices (P = .043). Patients with a history of sickle cell crises or bronchodilator use, along with those who had state funded insurance (P < .05), were more likely to have extended stays.

Conclusion: Factors from the history and physical of patients may predict which patients are at higher risk for extended hospital stays after tonsillectomy. Predictors of extended stays include younger and smaller children, those with a prior history of sickle cell crises, those using bronchodilators, and those with state funded health insurance.