Safety of Outpatient Tonsillectomy in Children: A Review of 6 Years in a Tertiary Hospital Experience

Abstract

OBJECTIVE: We present our experience with outpatient tonsillectomy in children and critically review safety to support the outpatient policy. STUDY DESIGN AND SETTING: We conducted a retrospective chart review from January 1995 through December 2000 in the pediatric otolaryngology unit of a tertiary care university hospital. RESULTS: One thousand two hundred forty-three patients were accepted in the outpatient program with permissive criteria. Postoperative observation time ranged from 3 to 5 hours (median, 4.5 hours). The overall rate of complications was 9.3% (n = 116). Primary and secondary bleeding rates were 6.27% (n = 78) and 0.48% (n = 6), respectively. Thirty-six children (2.9%) had major bleeding; 2 of them were not identified in day-hospital (0.16%). Discharge was delayed in 103 patients (8.3%), and 13 patients showed complications after discharge (about 1% readmission rate). CONCLUSION: Our program outcomes support safety. Outpatient surgery is meant to provide comfort to the patient and efficiency to the health care system, without impairing safety; in our experience, most tonsillectomies in children comply with these objectives. SIGNIFICANCE: Outpatient tonsillectomy in children may be safe even with permissive criteria, when an appropriate setting is available.