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Overnight in-hospital observation following tonsillectomy: retrospective study of post-operative intervention

  • S Morris (a1), E Hassin (a2) and M Borschmann (a2)
Abstract
Abstract Objective:

The safety of day-case tonsillectomy is widely documented in the literature; however, there are no evidence-based guidelines recommending patient characteristics that are incompatible with day-case tonsillectomy. This study aimed to identify which patients should be considered unsafe for day-case tonsillectomy based on the likelihood of needing critical intervention.

Method:

Retrospective review of 2863 tonsillectomy procedures performed at University Hospital Geelong from 1998 to 2014.

Results:

Of the patients, 7.81 per cent suffered a post-tonsillectomy complication and 4.15 per cent required intervention. The most serious complications, haemorrhage requiring a return to the operating theatre and airway compromise, occurred in 0.56 per cent and 0.11 per cent of patients respectively. The following patient characteristics were significantly associated with poorer outcomes: age of two years or less (p < 0.01), tonsillectomy indicated for neoplasm (p < 0.01) and quinsy (p < 0.05).

Conclusion:

The authors believe that all elective tonsillectomy patients should be considered for day-case surgery, with the following criteria necessitating overnight observation: age of two years or less; an indication for tonsillectomy of neoplasm or quinsy; and an American Society of Anesthesia score of more than 2.

Copyright
Corresponding author
Address for correspondence: Mr Simon Morris, 3 Orchard Grove, Morganstown, Cardiff CF15 8LS, Wales, UK E-mail: simonrhysmorris@yahoo.co.uk
Footnotes
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Presented at the 7th Royal College of Surgeons of Edinburgh All Wales Medical and Dental Student Surgical Research Symposium, 28 October 2016, Port Talbot, Wales, UK.

Footnotes
References
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
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