Postoperative morbidity and mortality after adenoidectomy: A national population-based study of 51 746 surgeries

Hanna Gerhardsson; Joacim Stalfors; Ola Sunnergren

doi:10.1016/j.ijporl.2022.111335

Postoperative morbidity and mortality after adenoidectomy: A national population-based study of 51 746 surgeries

Int J Pediatr Otorhinolaryngol. 2022 Dec:163:111335. doi: 10.1016/j.ijporl.2022.111335. Epub 2022 Oct 4.

Authors

Hanna Gerhardsson¹, Joacim Stalfors², Ola Sunnergren³

Affiliations

¹ Department of Otorhinolaryngology, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. Electronic address: hanna.gerhardsson@rjl.se.
² Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
³ Department of Otorhinolaryngology, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

PMID: 36265351
DOI: 10.1016/j.ijporl.2022.111335

Abstract

Objectives: To investigate postoperative morbidity and mortality after paediatric adenoidectomy.

Methods: This was a retrospective national population-based cohort study of data from the Swedish National Patient Register (NPR) and The Swedish Cause of Death Register (CDR). All patients aged 0-18 years who underwent adenoidectomy from 2007 to 2017 (without concomitant tonsil surgery) were included in this study. To evaluate postoperative morbidity and mortality, all diagnostic and surgical codes registered in the NPR for health care contacts within 30 days of surgery were analysed. The patients retrieved from the NPR were matched with the CDR to identify any deaths occurring within 30 days of the surgery.

Results: A total of 51 746 adenoidectomies were included in this study. No deaths related to adenoidectomy were identified. All types of haemorrhagic complications were rare. Only 0.1% of the surgeries resulted in an outpatient contact due to postoperative haemorrhage and only 0.1% of the adenoidectomies resulted in a readmission due to haemorrhage. The rarest haemorrhagic complication was RTT (return to theatre), with only 4 events (0.01%). Postoperative haemorrhage was most frequent on the first day after surgery. Other complications were rare as well, requiring a total of 922 (2.6%) outpatient visits and 75 (0.2%) readmissions in the adenoidectomy group, with postoperative infection being the most commonly reported.

Conclusions: Overall, adenoidectomy should be considered a safe surgical procedure associated with few postoperative complications. No deaths related to adenoidectomy were found. Severe complications, such as late postoperative haemorrhage after adenoidectomy, were rare, and haemorrhage resulting in RTT was even rarer. The highest rate of postoperative haemorrhage was observed the first day after surgery, and most haemorrhagic complications occurred within a week. Comparisons with studies on tonsil surgery show that adenoidectomy is associated with substantially lower postoperative morbidity.

Keywords: Adenoidectomy; Complication; Hemorrhage; Morbidity; Mortality.

MeSH terms

Adenoidectomy* / adverse effects
Child
Cohort Studies
Humans
Morbidity
Postoperative Complications / etiology
Postoperative Hemorrhage / epidemiology
Postoperative Hemorrhage / etiology
Retrospective Studies
Tonsillectomy* / adverse effects