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Comprehensive Otolaryngology

(028) An Analysis of Race and Ethnicity and Complications After Tonsillectomy

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

    Presenting Author(s)

  • Alison C. Ma, BS/MS

    Medical Student
    Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
    Buffalo, New York, United States

    • Co-Author(s)

  • RN

    Ryan E. Nagy, MD

    Resident
    Memorial Health System
    Amherst, NY, United States

  • Mattie R. Rosi-Schumacher, MD

    Resident Physician
    Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
    Buffalo, New York, United States

    • Senior Author(s)

  • Michele M. Carr, DDS MD PhD

    Professor
    Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
    Williamsville, NY, United States

Disclosure(s):
Alison C. Ma, BS/MS: No relevant relationships to disclose.
Mattie R. Rosi-Schumacher, MD: No relevant relationships to disclose.


Introduction: Tonsillectomies in adults are indicated for infection, hypertrophy, or asymmetry. The purpose of this study was to determine if race was associated with complications following adult tonsillectomy.

Methods: Patients who underwent tonsillectomy were identified using the 2017-2019 National Surgical Quality Improvement Program (NSQIP) database using Current Procedural Terminology code 42826. Data collected included patient demographics, comorbidities, ASA classification, inpatient status, perioperative descriptors, and complications. Non-parametric methods were utilized for the statistical analysis. A sub-analysis was performed after propensity score matching between those who identified as Caucasian and Black/African American.

Results: 8,521 patients underwent tonsillectomies, of which 6,502 reported their race. 5,173 patients reported as Caucasian and 1,329 patients reported as non-Caucasian, with 898 of those being Black/African American. Prior to sub-analysis, age at time of procedure was significantly higher in non-Caucasians 31.50 years (95% CI 30.86-32.14) than Caucasians (30.35 years) (95% CI 30.01-30.69) (P < .001). Non-Caucasians (13.9%) were significantly more likely to be admitted postoperatively compared to Caucasians (5.0%) (P < .001). Operation time (P < .001), length of stay (P < .001), incidence of cardiac arrest (P < .042), and percentage of those with hypertension treated with medications (P < .001) were higher in non-Caucasians. During matching, 737 Caucasian patients were matched to 898 Black/African American patients with nearest neighbor propensity scores. This process revealed that Caucasians (N=35, 4.7%) were significantly more likely to return to the OR for related reasons than Black/African Americans (N=24, 2.7%) (P < .036). The matched analysis revealed no other significant differences.

Conclusions: For patients included in the NSQIP database, race does not appear to significantly impact the incidence of complications for those who underwent tonsillectomy except for return to OR. More work is needed to clarify the reasons for this.