Socioeconomic status is associated with pediatric adenotonsillectomy outcomes: A single institution study.
Int J Pediatr Otorhinolaryngol
; 177: 111844, 2024 Feb.
Article
in En
| MEDLINE
| ID: mdl-38185004
ABSTRACT
OBJECTIVE:
Our institution serves a diverse patient population across a large metropolitan city. Literature has shown pediatric otolaryngology patients with lower socioeconomic status (SES) have higher rates of sleep-disordered breathing, delays in treatment time, and greater risks of complications post-tonsillectomy. This study aims to examine the effects of SES on adenotonsillectomy outcomes performed at our institution. STUDYDESIGN:
A retrospective chart review including 1560 pediatric patients (ages 0-18) who underwent adenotonsillectomy between January 2015 and December 2020.SETTING:
Large metropolitan hospital, level 1 trauma center.METHODS:
Outcome variables included postoperative hospital admission, phone calls, 30-day follow-up, and persistent obstructive sleep apnea (OSA). Descriptive statistics using Wilcoxon Signed Rank Tests and univariate and multivariate logistic regression modeling were used to determine statistically significant covariates at α = 0.05.RESULTS:
The cohort included Non-Hispanic White (n = 488, 31 %), Non-Hispanic Black (n = 801, 51 %), Hispanic (n = 210, 13 %), and other (n = 61, 4 %) groups. Using multivariate regression, privately insured patients were less likely to have moderate-to-severe OSA before surgery (0.65 95 % CI 0.45, 0.93 p = 0.017) and be admitted postoperatively (0.73, 0.55-0.96, p < 0.01), while more likely to have postoperative follow-up phone calls (1.57, 1.19-2.09, p < 0.01) and visits (1.53, 1.22-1.92, p < 0.01). Increased income was associated with decreased rehospitalizations within three months of surgery (0.98, 0.97-1.00, p < 0.01).CONCLUSION:
This study suggests SES significantly affects adenotonsillectomy outcomes. Further studies are warranted to provide better care for all pediatric patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tonsillectomy
/
Sleep Apnea, Obstructive
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
/
Equity_inequality
Limits:
Child
/
Humans
Language:
En
Journal:
Int J Pediatr Otorhinolaryngol
Year:
2024
Document type:
Article
Affiliation country:
United States