• Clin Otolaryngol · Feb 2018

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

    • I-S Chang, K-T Kang, C-C Tseng, W-C Weng, T-Y Hsiao, P-L Lee, and W-C Hsu.
    • Department of Otolaryngology, National Taiwan University, College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
    • Clin Otolaryngol. 2018 Feb 1; 43 (1): 39-46.

    ObjectiveTo investigate 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.DesignRetrospective chart review study.SettingTertiary referral centre.Participant610 consecutive children underwent T&A for treating SDB.Main Outcome MeasuresSleep-disordered breathing 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.ResultsOf these children (mean age = 7.2 years; males = 72%), 49 (8.0%) had first ER revisit, nine (1.5%) had second ER revisits, and one (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 eight children (13.5%), and admission for surgery in seven 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 years) experienced an increased risk of non-bleeding-related revisits (odds ratio [OR] = 4.1).ConclusionsChildren with severe SDB do not experience increased risks of revisit or readmission; however, young children are at increased risk of non-bleeding-related revisits.© 2017 John Wiley & Sons Ltd.

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