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A Population-Based Study of Acute Care Revisits following Tonsillectomy
Objectives To describe the clinical spectrum and frequency of acute care revisits after tonsillectomy in a population-based sample from a single state in the US. Study design We used California state discharge databases from 2009 to 2011 to retrospectively identify retrospectively routine tonsillect...
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| Published in: | The Journal of pediatrics 2015-03, Vol.166 (3), p.607-612.e5 |
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| creator | Edmonson, M. Bruce, MD, MPH Eickhoff, Jens C., PhD Zhang, Chong, MS |
| description | Objectives To describe the clinical spectrum and frequency of acute care revisits after tonsillectomy in a population-based sample from a single state in the US. Study design We used California state discharge databases from 2009 to 2011 to retrospectively identify retrospectively routine tonsillectomy discharges in residents |
| doi_str_mv | 10.1016/j.jpeds.2014.11.009 |
| format | article |
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Bruce, MD, MPH ; Eickhoff, Jens C., PhD ; Zhang, Chong, MS</creator><creatorcontrib>Edmonson, M. Bruce, MD, MPH ; Eickhoff, Jens C., PhD ; Zhang, Chong, MS</creatorcontrib><description>Objectives To describe the clinical spectrum and frequency of acute care revisits after tonsillectomy in a population-based sample from a single state in the US. Study design We used California state discharge databases from 2009 to 2011 to retrospectively identify retrospectively routine tonsillectomy discharges in residents <25 years of age and to establish record linkage to revisits within 30 days at ambulatory surgery, inpatient, and emergency department facilities statewide. Percentages and descriptive statistics were sample-weighted, and revisit rates were adjusted for demographic factors, expected payer, chronic conditions, surgical indication, facility type, and clustering. Results Records were available for 35 085 index tonsillectomies, most of which were performed at hospital-owned ambulatory and inpatient facilities. There were 4944 associated revisits: 3761 (75.9%) treat-and-release emergency room visits, 816 (17.1%) inpatient admissions, and 367 (7.0%) ambulatory surgery visits. Most revisits (3225 [67.7%]) were unrelated to bleeding; these typically occurred early (mode, day 2) and were commonly associated with diagnosis codes indicating pain, nausea/vomiting, or dehydration. Crude all-cause revisit and readmission rates were 10.5% and 2.1%, respectively. Adjusted all-cause revisit rates (range, 8.6%-24.5%) were lowest in young children, increased in adolescents, and peaked in young adults. Adjusted bleeding-related revisit rates increased abruptly in adolescents and reached 13.9% in males (6.8% in females, P < .001) ages 20-24 years. Conclusions Acute care revisits after tonsillectomy performed at predominately hospital-owned facilities in California are common and strongly age-related. Most revisits are early treat-and-release outpatient encounters, and these are usually associated with potentially preventable problems such as pain, nausea and vomiting, and dehydration.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2014.11.009</identifier><identifier>PMID: 25524315</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Child ; Child, Preschool ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Patient Readmission - statistics & numerical data ; Pediatrics ; Population Surveillance - methods ; Postoperative Complications - epidemiology ; Postoperative Complications - therapy ; Retrospective Studies ; Tonsillectomy ; Wisconsin - epidemiology ; Young Adult</subject><ispartof>The Journal of pediatrics, 2015-03, Vol.166 (3), p.607-612.e5</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-9de27390d8e9387a1b83782cb5a677d5bc32df70fcb2e851b3a774e1e8ac1adf3</citedby><cites>FETCH-LOGICAL-c484t-9de27390d8e9387a1b83782cb5a677d5bc32df70fcb2e851b3a774e1e8ac1adf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25524315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Edmonson, M. Bruce, MD, MPH</creatorcontrib><creatorcontrib>Eickhoff, Jens C., PhD</creatorcontrib><creatorcontrib>Zhang, Chong, MS</creatorcontrib><title>A Population-Based Study of Acute Care Revisits following Tonsillectomy</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objectives To describe the clinical spectrum and frequency of acute care revisits after tonsillectomy in a population-based sample from a single state in the US. Study design We used California state discharge databases from 2009 to 2011 to retrospectively identify retrospectively routine tonsillectomy discharges in residents <25 years of age and to establish record linkage to revisits within 30 days at ambulatory surgery, inpatient, and emergency department facilities statewide. Percentages and descriptive statistics were sample-weighted, and revisit rates were adjusted for demographic factors, expected payer, chronic conditions, surgical indication, facility type, and clustering. Results Records were available for 35 085 index tonsillectomies, most of which were performed at hospital-owned ambulatory and inpatient facilities. There were 4944 associated revisits: 3761 (75.9%) treat-and-release emergency room visits, 816 (17.1%) inpatient admissions, and 367 (7.0%) ambulatory surgery visits. Most revisits (3225 [67.7%]) were unrelated to bleeding; these typically occurred early (mode, day 2) and were commonly associated with diagnosis codes indicating pain, nausea/vomiting, or dehydration. Crude all-cause revisit and readmission rates were 10.5% and 2.1%, respectively. Adjusted all-cause revisit rates (range, 8.6%-24.5%) were lowest in young children, increased in adolescents, and peaked in young adults. Adjusted bleeding-related revisit rates increased abruptly in adolescents and reached 13.9% in males (6.8% in females, P < .001) ages 20-24 years. Conclusions Acute care revisits after tonsillectomy performed at predominately hospital-owned facilities in California are common and strongly age-related. Most revisits are early treat-and-release outpatient encounters, and these are usually associated with potentially preventable problems such as pain, nausea and vomiting, and dehydration.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Emergencies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Pediatrics</subject><subject>Population Surveillance - methods</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - therapy</subject><subject>Retrospective Studies</subject><subject>Tonsillectomy</subject><subject>Wisconsin - epidemiology</subject><subject>Young Adult</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqFkcFu1DAQhi0EokvhCZBQjlwSZuwkTg4gLSsoSJVAtJwtx54gB2-82EnRvj1etnDgwmku3z-j-X7GniNUCNi-mqrpQDZVHLCuECuA_gHbIPSybDshHrINAOelqGV7wZ6kNEEmaoDH7II3Da8FNht2tS0-h8Pq9eLCXL7ViWxxs6z2WISx2Jp1oWKnIxVf6M4lt6RiDN6Hn27-VtyGOTnvySxhf3zKHo3aJ3p2Py_Z1_fvbncfyutPVx932-vS1F29lL0lLkUPtqNedFLj0AnZcTM0upXSNoMR3I4SRjNw6hochJayJqROG9R2FJfs5XnvIYYfK6VF7V0y5L2eKaxJYSsF5IiEjIozamJIKdKoDtHtdTwqBHUyqCb126A6GVSIKvvJqRf3B9ZhT_Zv5o-yDLw-A5TfvHMUVTKOZkPWxexC2eD-c-DNP3nj3eyM9t_pSGkKa5yzQYUqcQXq5lTiqUOsAaFFEL8AAJSXgw</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Edmonson, M. Bruce, MD, MPH</creator><creator>Eickhoff, Jens C., PhD</creator><creator>Zhang, Chong, MS</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150301</creationdate><title>A Population-Based Study of Acute Care Revisits following Tonsillectomy</title><author>Edmonson, M. Bruce, MD, MPH ; Eickhoff, Jens C., PhD ; Zhang, Chong, MS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-9de27390d8e9387a1b83782cb5a677d5bc32df70fcb2e851b3a774e1e8ac1adf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Emergencies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Pediatrics</topic><topic>Population Surveillance - methods</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - therapy</topic><topic>Retrospective Studies</topic><topic>Tonsillectomy</topic><topic>Wisconsin - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Edmonson, M. Bruce, MD, MPH</creatorcontrib><creatorcontrib>Eickhoff, Jens C., PhD</creatorcontrib><creatorcontrib>Zhang, Chong, MS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Edmonson, M. Bruce, MD, MPH</au><au>Eickhoff, Jens C., PhD</au><au>Zhang, Chong, MS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Population-Based Study of Acute Care Revisits following Tonsillectomy</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>166</volume><issue>3</issue><spage>607</spage><epage>612.e5</epage><pages>607-612.e5</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>Objectives To describe the clinical spectrum and frequency of acute care revisits after tonsillectomy in a population-based sample from a single state in the US. Study design We used California state discharge databases from 2009 to 2011 to retrospectively identify retrospectively routine tonsillectomy discharges in residents <25 years of age and to establish record linkage to revisits within 30 days at ambulatory surgery, inpatient, and emergency department facilities statewide. Percentages and descriptive statistics were sample-weighted, and revisit rates were adjusted for demographic factors, expected payer, chronic conditions, surgical indication, facility type, and clustering. Results Records were available for 35 085 index tonsillectomies, most of which were performed at hospital-owned ambulatory and inpatient facilities. There were 4944 associated revisits: 3761 (75.9%) treat-and-release emergency room visits, 816 (17.1%) inpatient admissions, and 367 (7.0%) ambulatory surgery visits. Most revisits (3225 [67.7%]) were unrelated to bleeding; these typically occurred early (mode, day 2) and were commonly associated with diagnosis codes indicating pain, nausea/vomiting, or dehydration. Crude all-cause revisit and readmission rates were 10.5% and 2.1%, respectively. Adjusted all-cause revisit rates (range, 8.6%-24.5%) were lowest in young children, increased in adolescents, and peaked in young adults. Adjusted bleeding-related revisit rates increased abruptly in adolescents and reached 13.9% in males (6.8% in females, P < .001) ages 20-24 years. Conclusions Acute care revisits after tonsillectomy performed at predominately hospital-owned facilities in California are common and strongly age-related. Most revisits are early treat-and-release outpatient encounters, and these are usually associated with potentially preventable problems such as pain, nausea and vomiting, and dehydration.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25524315</pmid><doi>10.1016/j.jpeds.2014.11.009</doi></addata></record> |
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| subjects | Adolescent Adult Child Child, Preschool Emergencies Female Follow-Up Studies Humans Incidence Infant Infant, Newborn Male Patient Readmission - statistics & numerical data Pediatrics Population Surveillance - methods Postoperative Complications - epidemiology Postoperative Complications - therapy Retrospective Studies Tonsillectomy Wisconsin - epidemiology Young Adult |
| title | A Population-Based Study of Acute Care Revisits following Tonsillectomy |
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