Children From Poor Households More Likely to Suffer From Post-Tonsillectomy Complications

Children from lower-income families are more likely to suffer from post-tonsillectomy complications, a new study states.

Tonsillectomy is a 3,000-year-old surgical procedure in which each tonsil is removed. Tonsils are glands located at the back of the throat and are often removed along with the adenoid glands. Though the number of tonsillectomies performed on kids has declined over the last 30 years, it is one of the most common surgical procedures in the United States, with over 530,000 procedures performed annually in children under 15 years of age.

In the latest study, researchers at the University of California, Los Angeles Health Sciences, found that post-tonsillectomy those children from lower-income families are more likely to suffer from complications. This is the first study that analyzes the post-operative complication that requires doctors to visit within the initial 14 days after the surgery. The researchers were surprised to see a significant disparity that was based on income status, ethnicity and race.

"Surprisingly, despite all children having a relatively uniform health status before surgery, we found significant differences in the numbers of children requiring revisits after their tonsillectomies," said co-author Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children's Hospital UCLA and a professor of head and neck surgery at the David Geffen School of Medicine at UCLA.

For this study, the researchers looked at the rate of complication in more than 80,000 children who had undergone the tonsillectomy surgery in an outpatient setting in over four states that included California, Iowa, Florida and New York. They also analyzed the surgery database from 2010-2011 and associated them to the emergency room and inpatient databases. They again analyzed the revisit rates and diagnoses in 14 days post the surgery with respect to the gender, race and median household income level.

On the whole, they noticed that 8 percent of the children visited the doctor within two weeks after the surgery as they experienced certain complications that included bleeding, pain and dehydration/fever.

They also noticed that as compared to children from higher income group, it was children from the lower income households who were one and half times more likely to suffer from complications and meet the doctor after the surgery. They had one and one third risk of bleeding after the surgery. As compared to the white children, it was the black and Hispanic children who were more likely to suffer from complications.

"One possibility is that families in the higher income group may have had easier access to communication with their doctor via phone or email, alleviating the need for doctor visits," said co-author Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children's Hospital UCLA and a professor of head and neck surgery at the David Geffen School of Medicine at UCLA. "Another possibility is that children in the lower income group may have had low-grade chronic illnesses or infections, making them more susceptible to postoperative problems. Or, educational level and possible language barriers may have played a role in postoperative outcomes."

The finding was documented in online edition of Otolaryngology-Head and Neck Surgery.