Revisits after adenotonsillectomy in children with sleep-disordered breathing: a retrospective single-institution study

Abstract

Objective

To investigated emergency room (ER) revisits and hospital readmissions following adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB), and correlations between SDB severity and ER revisits.

Design

Retrospective chart-review study.

Setting

Tertiary referral centre.

Participant

610 consecutive children underwent T&A for treating SDB.

Main outcome measures

SDB severity was defined according to the apnoea–hypopnoea index (AHI) (primary snoring = AHI < 1; mild = AHI 1–5; moderate = AHI 5–10; and severe = AHI > 10). Revisit and readmission patterns within 30 days of the surgery were extracted and analysed.

Results

Of these children (mean age = 7.2 y; males = 72%), 49 (8.0%) had first ER revisit, 9 (1.5%) had second ER revisits, and 1 (0.2%) had third ER revisits. Reasons for ER revisits were bleeding related (46%) or non-bleeding related (54%). The timing for revisits was 6.9 ± 1.9 postoperative days for bleeding-related revisits and 9.3 ± 10.0 days for non-bleeding-related revisits. Treatment strategies during these revisits were treat and release in 44 children (74.6%), admission for observation in 8 children (13.5%), and admission for surgery in 7 children (11.9%). The incidence of ER revisit and hospital readmission was similar among children with all levels of SDB severity. Multivariable logistic regression analysis showed that young children (<3 y) experienced an increased risk of non-bleeding-related revisits (odds ratio [OR] = 4.1).

Conclusions

Children with severe SDB do not experience increased risks of revisit or readmission; however, young children are at increased risk of non-bleeding-related revisits.

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