Postoperative mortality likely in children undergoing tonsillectomy? - Video

Published On 2022-06-22T10:00:57+05:30 | Updated On 26 Jun 2022 12:25 AM IST

Overview

The increasing rates of postoperative death in children under going tonsillectomy is uncertain. Mortality rates are not separately reported for children at increased risk of complications, including young children (aged <3 y) and those with sleep-disordered breathing or complex chronic conditions.

A recent retrospective cohort study published in JAMA Network included close to 5 lac Participants youngerthan21years for whom discharge records were available to link out patient or inpatient tonsillectomy with at least 90daysoffollow-up.

Postoperativedeathwas characterized as death within 30 days or during a surgical stay lasting more than 30 days. Out of the Total of 5 lac children, 10.1%tonsillectomies were performed in young children, 28.9%inthosewithsleep-disordered breathing, and 2.8%inthosewith complex chronic conditions. It was found that there were36postoperative deaths, which occurred in 4.5 day safter surgical admission, and most of which occurred after surgical discharge.

Additionally, neither those youngerthan3years nor sleep-disordered breathing was significantly associated with mortality, but children with complex chronic conditions had significantly higher mortality. Children with complex chronic conditions accounted for 2.8%oftonsillectomies but 44%of postoperative deaths. Most deaths associated with complex chronic conditions occurred in children with neurologic/neuromuscular or congenital/genetic disorders.

Therefore, the researchers concluded that among children under going tonsillectomy,the rate of postoperative death was7per100000operationsoveralland117per100000operations among children with complex chronic conditions. Hence, these findings may help practitioners in decision-making before performing pediatric tonsillectomy.

Reference: Edmonson MB, Zhao Q, Francis DO, et al. Association of Patient Characteristics With Postoperative Mortality in Children Undergoing Tonsillectomy in 5 US States. JAMA. 2022;327(23):2317–2325. doi:10.1001/jama.2022.8679.

Speakers

Dr. Nandita Mohan

Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751