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Pediatric Otolaryngology

(248) Impact of Developmental Delay on Tonsillectomy Outcomes

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • HD

    Harlee Dwyer, BS

    Medical Student
    University of Tennessee Health Science Center College of Medicine
    Franklin, Tennessee, United States

    • Co-Author(s)

  • Joseph M. Berry, B.S.

    Clinical Research Fellow; M4 Medical Student
    University of Tennessee Health and Science Center; University of Mississippi Medical Center
    Jackson, Mississippi, United States

  • Camron M. Davies, MD

    Resident Physician
    Loma Linda University Health
    Riverside, California, United States

  • Dhruv S. Kothari, MD

    Otolaryngology Resident
    Cedars-Sinai Medical Center
    Los Angeles, California, United States

  • JL

    Jordan B. Luttrell, MD

    Resident
    University of Tennessee
    Memphis, TN, United States

    • Senior Author(s)

  • RY

    Robert J. Yawn, MD, MBA

    University of Tennessee Health Science Center, USA

  • Anthony M. Sheyn, MD, FACS

    Division Chief, Pediatric Otolaryngology
    LeBonheur Children's Hospital
    Memphis, Tennessee, United States

Disclosure(s):
Harlee Dwyer, BS: No relevant relationships to disclose.
Joseph M. Berry, B.S.: No relevant relationships to disclose.
Camron M. Davies, MD: No relevant relationships to disclose.
Dhruv S. Kothari, MD: No relevant relationships to disclose.
Anthony M. Sheyn, MD, FACS: No relevant relationships to disclose.


Introduction: Children with developmental delay (DD) have a higher prevalence of comorbidities that indicate necessity of tonsillectomy. DD poses a risk for postoperative complications and readmissions following tonsillectomy. This study aims to compare the outcomes following surgical intervention in DD children and non-DD controls using TriNetX datasets.

Methods: A retrospective analysis using TriNetX datasets from 2014 to present compared the outcomes of two cohorts: Cohort 1 (1,020 patients) named Tonsillectomy with Developmental Delay < 18 and Cohort 2 (6,480 patients) named Tonsillectomy without Developmental Delay < 18. The populations were matched for demographics, leaving 990 patients in each cohort. The following outcomes were measured: fever (T 101.00 F), elevated WBCs (12.00 10*13/uL), need for antibiotics, need for opioids, surgical complications, ER visit, and dehydration.

Results: Results are presented as odds ratios with 95% confidence interval (OR [95%CI]). The preliminary analyses show Cohort 1 is at an increased risk for being prescribed an antibiotic within POD 1-7 [OR]:1.385, [1.160, 1.653], and significance in return visits to the ER risk [OR]:1.477, [1.073, 2.032]. There was no significance in incidence of fever, opioids, surgical complications, or dehydration between the two cohorts.

Conclusions: Our analyses indicate that children with DD following tonsillectomy were both at an increased risk of requiring antibiotics postoperatively and requiring return to the ER post operatively. Given the negative outcomes that were established, there is need for additional prospective studies to further evaluate these variables in DD children to establish better preoperative decision making and treatment plans.