OBJECTIVE/HYPOTHESIS: To report data on death or permanent disability after tonsillectomy. STUDY DESIGN: Electronic mail survey. METHODS: A 32-question survey was disseminated via the American Academy of Otolaryngology-Head and Neck Surgery electronic newsletter. Recipients were queried regarding adverse events after tonsillectomy, capturing demographic data, risk factors, and detailed descriptions. Events were classified using a hierarchical taxonomy. RESULTS: A group of 552 respondents reported 51 instances of post-tonsillectomy mortality, and four instances of anoxic brain injury. These events occurred in 38 children (71%), 15 adults (25%), and two patients of unstated age (4%). The events were classified as related to medication (22%), pulmonary/cardiorespiratory factors (20%), hemorrhage (16%), perioperative events (7%), progression of underlying disease (5%), or unexplained (31%). Of unexplained events, all but one occurred outside the hospital. One or more comorbidities were identified in 58% of patients, most often neurologic impairment (24%), obesity (18%), or cardiopulmonary compromise (15%). A preoperative diagnosis of obstructive sleep apnea was not associated with increased risk of death or anoxic brain injury. Most events (55%) occurred within the first 2 postoperative days. Otolaryngologists who reported performing <200 tonsillectomies per year were more likely to report an event (P < .001). CONCLUSIONS: This study, the largest collection of original reports of post-tonsillectomy mortality to date, found that events unrelated to bleeding accounted for a preponderance of deaths and anoxic brain injury. Further research is needed to establish best practices for patient admission, monitoring, and pain management. LEVEL OF EVIDENCE: N/A.
OBJECTIVE/HYPOTHESIS: To report data on death or permanent disability after tonsillectomy. STUDY DESIGN: Electronic mail survey. METHODS: A 32-question survey was disseminated via the American Academy of Otolaryngology-Head and Neck Surgery electronic newsletter. Recipients were queried regarding adverse events after tonsillectomy, capturing demographic data, risk factors, and detailed descriptions. Events were classified using a hierarchical taxonomy. RESULTS: A group of 552 respondents reported 51 instances of post-tonsillectomy mortality, and four instances of anoxic brain injury. These events occurred in 38 children (71%), 15 adults (25%), and two patients of unstated age (4%). The events were classified as related to medication (22%), pulmonary/cardiorespiratory factors (20%), hemorrhage (16%), perioperative events (7%), progression of underlying disease (5%), or unexplained (31%). Of unexplained events, all but one occurred outside the hospital. One or more comorbidities were identified in 58% of patients, most often neurologic impairment (24%), obesity (18%), or cardiopulmonary compromise (15%). A preoperative diagnosis of obstructive sleep apnea was not associated with increased risk of death or anoxic brain injury. Most events (55%) occurred within the first 2 postoperative days. Otolaryngologists who reported performing <200 tonsillectomies per year were more likely to report an event (P < .001). CONCLUSIONS: This study, the largest collection of original reports of post-tonsillectomy mortality to date, found that events unrelated to bleeding accounted for a preponderance of deaths and anoxic brain injury. Further research is needed to establish best practices for patient admission, monitoring, and pain management. LEVEL OF EVIDENCE: N/A.
Authors: Ronald D Chervin; Susan S Ellenberg; Xiaoling Hou; Carole L Marcus; Susan L Garetz; Eliot S Katz; Elise K Hodges; Ron B Mitchell; Dwight T Jones; Raanan Arens; Raouf Amin; Susan Redline; Carol L Rosen Journal: Chest Date: 2015-11 Impact factor: 9.410
Authors: S Sadhasivam; V Chidambaran; X Zhang; J Meller; H Esslinger; K Zhang; L J Martin; J McAuliffe Journal: Pharmacogenomics J Date: 2014-10-14 Impact factor: 3.550
Authors: Arlyne K Thung; Charles A Elmaraghy; N'Diris Barry; Dmitry Tumin; Kris R Jatana; Julie Rice; Vidya Raman; Tarun Bhalla; David P Martin; Marco Corridore; Joseph D Tobias Journal: J Pediatr Pharmacol Ther Date: 2017 Sep-Oct