Ethnic Disparities among Pediatric Tonsillectomy Patients

Abstract

Objectives:

Study ethnic disparities in rates of complications in inpatient pediatric tonsillectomy patients.

Methods:

Study Design: Retrospective cohort study. Setting: USA pediatric discharge samples from 2003, 2006, and 2009 calendar years. Method: This study examined inpatient admissions for pediatric tonsillectomy in 2003, 2006, and 2009 using the Kids’ Inpatient Database (KID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Outcomes were analyzed for racial disparities. Pearson chi-squared was used to analyze categorical data and linear regression for continuous variables. Logistical regression and multivariate linear regression models were created to assess for confounding and to create odds ratios.

Results:

The estimated population of inpatient pediatric patients who underwent tonsillectomy was 82,222. Forty-two percent were female. The ethnic breakdown was: 52% white, 20% black, 19% Hispanic, 2% Asian, 6% other. The mean length of stay was 2.3 days and the complication rate was 18%. The postoperative bleed rate was 13% and 2% required a blood transfusion. Black children had longer hospital stays (3.0 days vs 2.1 days, P < .01), more respiratory complications (31% vs 21%, P < .01), higher postoperative intubation rates (7% vs 2%, P < .01), and needed more blood transfusion (3.6% vs 1.7%, P < .01). White children were more likely to have postoperative bleeding (17% vs 9%, P < .01). Approximately 0.06% of patients died with no ethnic predilection.

Conclusions:

Ethnic disparities exist among pediatric inpatient tonsillectomy patients. Further research to understand the etiology of these differences is necessary.