Impact of Concomitant Tonsillectomy on the Management and Outcomes of Pediatric Adenoidectomy

Adenoidectomy is a common otolaryngologic procedure that may be performed with concomitant tonsillectomy (T&A). This study investigates differences between pediatric inpatients undergoing adenoidectomy alone and T&A. The 2016 Kid's Inpatient Database was used to identify pediatric patients undergoing adenoidectomy (ICD-10: 0CTQXZZ) with and without tonsillectomy (ICD-10: 0CTP, 0CBP). Common comorbidities, postoperative complications, and procedures undergone were identified via ICD-10 codes. Univariate and multivariable analyses were performed to determine statistical associations with tonsillectomy status. Of the 5,540 inpatients who met inclusion criteria, the majority underwent T&A (88.9%). Mean patient age was 4.9 years. On multivariable analysis adjusting for patient demographics, hospital data, and severity of illness, T&A patients had similar total charges ($35,442 vs. $48,577, p = 0.880), length of stay (LOS) (2.5 vs. 3.9 days, p = 0.070), and number of procedures undergone (3.3 vs. 3.8 procedures, p = 0.884) as adenoidectomy alone patients. T&A patients had lower odds for undergoing ear, nose, sinus, mouth, or throat inspection (OR 0.59, 95% CI 0.46-0.75) and drainage (OR 0.56, 95% CI 0.46-0.68), bronchoscopy (OR 0.57, 95% CI 0.44-0.75), laryngoscopy (OR 0.64, 95% CI 0.49-0.83), and imaging (OR 0.56, 95% CI 0.32-0.996) than adenoidectomy alone patients (p < 0.05). T&A patients had higher odds for undergoing control of bleeding in the head and neck (OR 8.09, 95% CI 1.49-43.91, p < 0.001). Odds for undergoing ear, nose, sinus, mouth, or throat inspection and drainage, bronchoscopy, laryngoscopy, imaging, and control of bleeding in the head and neck varied by tonsillectomy status.