Consecutive pediatric adenoidectomy without tonsillectomy cases in children younger than 2-years-old with subsequent inpatient observation from January 2014 to October 2018 were reviewed at a single tertiary children’s institution using electronic medical records. Patient demographics, surgical data, and comorbidities were analyzed for correlations with postoperative complications or interventions.
Out of the 76 patients with sleep-disordered breathing (SDB) examined, one patient (1.3%) required readmission for postoperative dehydration and seven patients (9.2%) required intervention. The presence of at least one major comorbidity was significantly associated with increased incidence of complication or intervention compared to patients with no major comorbidities (18.9% vs. 2.6%, p = 0.03). Specifically, O nadir <80% (p = 0.01), craniofacial syndrome (p = 0.01) and seizure history (p = 0.007) were significant factors of complication or intervention.
Otherwise healthy children (>18-month-old) with SDB may be considered for discharge the same day of surgery. Children younger than 2-years-old with ≥1 major comorbidities may benefit from overnight inpatient observation. Otherwise healthy children younger than 18-months-old or children with a history of RAD or CLD should be managed on a case-by-case basis.
Copyright © 2020 Elsevier Inc. All rights reserved.