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Risk of Post-Tonsillectomy Complications Up for Under-3s

Increased risk of complications, complications within 24 hours of surgery, compared with older children

FRIDAY, March 16, 2018 (HealthDay News) — Children aged younger than 3 years seem to have increased risk of complications following tonsillectomy compared with children aged 3 years or older, according to a study published online March 15 in JAMA Otolaryngology-Head & Neck Surgery.

Claire M. Lawlor, M.D., from the Tulane University School of Medicine in New Orleans, and colleagues reviewed medical records for 2,139 consecutive children (<6 years of age) who underwent tonsillectomy between 2005 and 2015. A total of 1,817 children met the inclusion criteria and were included in the analyses.

The researchers found that 5.2 percent of patients (95 children) had a postoperative complication. Overall, 7.0 percent of children aged younger than 3 years and 4.6 percent of those aged 3 years or older had a complication (odds ratio, 1.56; 95 percent confidence interval [CI], 1.00 to 2.42). Compared with children aged 3 years or older, children aged younger than 3 years were more likely experience a complication within the first 24 hours after surgery (25 versus 9.5 percent; odds ratio, 3.17; 95 percent CI, 1.00 to 10.11). Regardless of age, children admitted to the hospital had a greater risk of complication than those treated as outpatients (6.9 versus 93.0 percent; odds ratio, 3.49; 95 percent CI, 2.02 to 6.05). There was no correlation noted between weight and complications.

“Children younger than 3 years may benefit from 23-hour observation after tonsillectomy; clinician judgment is crucial in determining which patients are safe for outpatient tonsillectomy,” the authors write.

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