Reoperation following Adult Tonsillectomy: Review of the American College of Surgeons National Surgical Quality Improvement Program. (May 2016)

• Record Type: Journal Article
• Authors: Brant, Jason A.; Bur, Andrés M.; Chai, Raymond; Hatten, Kyle; Nicolli, Elizabeth A.; Fischer, John P.; Cannady, Steven B.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 154:Number 5(2016:May)
• Page Start: 779
• Page End: 784
• Publication Date: 2016-05
• Subjects: tonsillectomy -- complications -- reoperation -- NSQIP; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599816630239
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: Tonsillectomy remains a common procedure in adults; however, there are few population-level data evaluating risk factors for reoperation. Study Design: Retrospective review of national database. Setting: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2005-2013. Subjects and Methods: The ACS-NSQIP was queried for patients undergoing tonsillectomy ± adenoidectomy as their primary procedure ( CPT 42821 or 42826). Demographic information and indications were reviewed along with complications and reoperation rates. Results: In total, 12, 542 cases met inclusion criteria. Patients were predominantly female (66.4%) and white (70.8%), with mean age of 30 ± 12 years (range: 16-90+). Thirty-day mortality was 0.03%, and 4.8% of patients experienced at least 1 complication, including reoperation (3.6%). Risk of complications was associated with male sex ( P < .0001; odds ratio [OR], 1.7), diabetes ( P = .0002; OR, 2.1), and presence of a bleeding disorder ( P = .002; OR, 3.2). Risk factors for reoperation were similar, in addition to older age ( P = .002; OR, 0.986). Complications other than reoperation were correlated with older age ( P = .001; OR, 1.02) and diabetes ( P = .001; OR, 2.59). Procedures were done mostly for infectious/inflammatory (70.4%) versus hypertrophic (16.4%) indications. Indication had no significant effect on the rate of reoperation. Most reoperations occurred after postoperative day 1 (86%; mean, 6.4 ± 4.2 days). Conclusion: This review of a large validated surgical database provides an overview of the rates of, and risk factors for, complications and reoperations following tonsillectomy in the adult population.