Abstract
Objective/Hypothesis To report data on death or permanent disability after tonsillectomy. Study Design Electronic mail survey. Methods A 32-question survey was disseminated via the American Academy of Otolaryngology-Head and Neck Surgery electronic newsletter. Recipients were queried regarding adverse events after tonsillectomy, capturing demographic data, risk factors, and detailed descriptions. Events were classified using a hierarchical taxonomy. Results A group of 552 respondents reported 51 instances of post-tonsillectomy mortality, and four instances of anoxic brain injury. These events occurred in 38 children (71%), 15 adults (25%), and two patients of unstated age (4%). The events were classified as related to medication (22%), pulmonary/cardiorespiratory factors (20%), hemorrhage (16%), perioperative events (7%), progression of underlying disease (5%), or unexplained (31%). Of unexplained events, all but one occurred outside the hospital. One or more comorbidities were identified in 58% of patients, most often neurologic impairment (24%), obesity (18%), or cardiopulmonary compromise (15%). A preoperative diagnosis of obstructive sleep apnea was not associated with increased risk of death or anoxic brain injury. Most events (55%) occurred within the first 2 postoperative days. Otolaryngologists who reported performing <200 tonsillectomies per year were more likely to report an event (P <.001). Conclusions This study, the largest collection of original reports of post-tonsillectomy mortality to date, found that events unrelated to bleeding accounted for a preponderance of deaths and anoxic brain injury. Further research is needed to establish best practices for patient admission, monitoring, and pain management. Laryngoscope, 123:2544-2553, 2013 Level of Evidence N/A.
Original language | English (US) |
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Pages (from-to) | 2544-2553 |
Number of pages | 10 |
Journal | Laryngoscope |
Volume | 123 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2013 |
Keywords
- Tonsillectomy
- clinical practice guideline
- complications
- hemorrhage
- morbidity
- mortality
- obstructive sleep apnea
- patient safety
- quality
- survey
- tonsillitis
ASJC Scopus subject areas
- Otorhinolaryngology