home
RSS
'Routine' tonsillectomies not so routine
January 20th, 2014
11:18 AM ET

'Routine' tonsillectomies not so routine

When Jahi McMath suffered severe complications following a tonsillectomy, and doctors declared her brain dead, many parents were shocked.

More than 500,000 tonsillectomies are performed each year on children in the United States; it's the second most common pediatric surgery. But how routine are these procedures really?

Not so much, a new study published Monday in the scientific journal Pediatrics suggests. Researchers found the quality of care before, during and after a tonsillectomy varies greatly depending on the hospital.

When routine surgeries go wrong

"We were surprised at the degree of variation between hospitals in the use of medications ... and revisits to hospitals after the surgery for complications," said lead study author Dr. Sanjay Mahant.

The study

Researchers analyzed data from the Pediatric Health Information System, looking specifically at 139,155 low-risk children who underwent tonsillectomies between 2004 and 2010 at 36 children's hospitals across the United States.

Guidelines from the American Academy of Otolaryngology-Head and Neck Surgery recommend doctors administer dexamethasone on the day of a tonsillectomy.  Dexamethasone is used to reduce nausea and pain after surgery. The guidelines do not recommend administering antibiotics because previous studies have shown that antibiotics do not help in preventing bleeding, pain or infection after a tonsillectomy.

In addition to looking at whether hospital staff followed these guidelines, Mahant and his team also calculated the number of patients who returned to the hospital in the 30 days after surgery for bleeding, vomiting/dehydration, pain, infection and/or respiratory problems.

The results

Close to 70% of patients received dexamethansone on the day of their surgery. Nearly a third received antibiotics.

A total of 10,868 children - about 7.8% - returned to the hospital after being discharged, most for bleeding and vomiting/dehydration. Those who came in with vomiting tended to return one to two days after being discharged. Those who returned with bleeding were most likely to come in six to seven days after.

Older children were more likely to suffer from bleeding problems while younger kids were more likely to experience nausea. 

Trends

The researchers also looked at dexamethasone and antibiotic use over time, as well as the revisit rate during the study period. Dexamethasone use did not change between 2004 and 2010, but the use of antibiotics dropped significantly. The hospital revisit rate remained fairly stagnant.

Mahant and his team have held webinars with hospital administrators to educate them about the study results.

"There is definitely more work that needs to be done to understand how to reduce revisits to hospital for complications," Mahant told CNN. "One way to investigate this is by studying and learning from high-performing hospitals."

Keeping your kid safe

Parents and doctors should discuss the risks and benefits of any surgery, Mahant said.

For some children, a tonsillectomy is the necessary, or sensible option. However, he said, there are many unanswered questions regarding the the benefits of tonsillectomies for treating certain issues, such as sleep apnea.

"Parents should educate themselves about their child’s condition and treatment options, and ask questions so they feel comfortable about their decisions," he said.


soundoff (716 Responses)
  1. shredder hammer

    Chrome plating looks an dreadful whole lot like things made from stainless steel Yet which product is better? Learn about the pros and cons of each.

    https://articlescad.com/how-to-prolong-cone-crusher-liners-cover-life-1114849.html

    April 7, 2021 at 15:46 | Report abuse | Reply
  2. Ni hard mill liners

    Additionally called carbon steel, this product is just one of the most common choices you'll find for bearings The 52100 bearing steel is a high carbon, reduced alloy steel which contains chromium. These features make chrome steel a excellent choice for a lot of general applications seeking thin section bearings.

    http://castingquestionscit.bravesites.com/entries/general/how-to-locate-the-best-cone-crusher-parts-supplier-

    April 7, 2021 at 18:10 | Report abuse | Reply
  3. tadalafil 40

    tadalafil 40 https://elitadalafill.com/ generic tadalafil

    April 7, 2021 at 18:42 | Report abuse | Reply
  4. no prescription generic sildenafil online

    buy sildenafil over the counter https://eunicesildenafilcitrate.com/ buy sildenafil 25 mg

    April 7, 2021 at 21:58 | Report abuse | Reply
  5. 카지노사이트

    Wow, the articles are so sexy. How can certainly My spouse and i write like anyone? I actually want the exact same writing skills when you.

    http://www.satechhelp.co.za/index.php?qa=user&qa_1=pillowanger41

    April 7, 2021 at 22:16 | Report abuse | Reply
  6. 우리카지노

    Thank anyone so much with regard to letting me know what I actually didn't know. I look ahead to working with you.

    http://bookmarkswing.com/story9068461/the-way-to-upgrade-your-slots-on-your-personal-computer

    April 8, 2021 at 03:34 | Report abuse | Reply
  7. generic tadalafil united states

    tadalafil https://elitadalafill.com/ tadalafil 40 mg from india

    April 8, 2021 at 06:16 | Report abuse | Reply
  8. generic vardenafil 20mg

    vardenafil generic https://vegavardenafil.com/ levitra generic vardenafil

    April 8, 2021 at 07:27 | Report abuse | Reply
  9. 카지노사이트

    Just what a man of capacity! You have the power to compose excellent factors that you can't get at any place. to envy

    http://www.sericalprint.it/index.php?option=com_k2&view=itemlist&task=user&id=990158

    April 8, 2021 at 08:50 | Report abuse | Reply
  10. Rolande Ariola

    I simply had to appreciate you again. I am not sure what I could possibly have taken care of in the absence of those ways revealed by you concerning that question. Previously it was the horrifying issue in my opinion, nevertheless spending time with this skilled approach you solved the issue forced me to leap over contentment. I'm happier for this help and in addition wish you comprehend what a great job you're accomplishing teaching the others by way of a web site. Most likely you've never met any of us.

    http://www.google.ba/url?q=https://favro.com/organization/9c95001d84d8a042b667b06c/5ce2065fbd5351af17462537

    April 8, 2021 at 21:10 | Report abuse | Reply
  11. Hector Ramon

    Good day! I know this is kind of off topic but I was wondering which blog platform are you using for this website? I'm getting sick and tired of WordPress because I've had problems with hackers and I'm looking at options for another platform. I would be fantastic if you could point me in the direction of a good platform.

    http://cse.google.com.do/url?q=https://favro.com/organization/9c95001d84d8a042b667b06c/5ce2065fbd5351af17462537?card=vie-43

    April 9, 2021 at 00:39 | Report abuse | Reply
  12. Donnie Kearney

    http://www.google.de

    April 9, 2021 at 04:59 | Report abuse | Reply
  13. Romelia Lindroth

    http://www.google.de

    April 9, 2021 at 05:10 | Report abuse | Reply
  14. Madonna Sandager

    http://www.google.de

    April 9, 2021 at 05:40 | Report abuse | Reply
  15. Mable Portman

    http://www.google.de

    April 9, 2021 at 06:15 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Leave a Reply to 3d Rendering Services


 

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

Advertisement
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.