Healthcare disparities in revisits for complications after adult tonsillectomy

Abstract

Objective: Determine if disparities exist for revisit complications after adult tonsillectomy.

Methods: Cases of adult tonsillectomy were extracted from the state ambulatory surgery databases and linked to the state emergency department databases and inpatient databases for California, Iowa, Florida and New York for 2010 and 2011. Revisits within 14days for diagnoses of: post-tonsillectomy bleeding, acute pain and nausea/vomiting/dehydration were determined and analyzed for associations of these complications with age, sex, race, median household income and comorbidity score.

Results: Among 17,836 tonsillectomies (63.7% female; mean age, 29.0years), revisit rates for post-tonsillectomy bleeding, acute pain and fever/dehydration were 5.1, 2.8 and 1.5%, respectively. On multivariate analysis, only female sex was associated with a lower post-tonsillectomy bleeding rate (odds, 0.48, p<0.001). Decreasing household income, female sex, black and Hispanic race were associated with increased revisits for acute pain (odds, 1.21, 1.49, 2.03 and 1.32, p≤0.002). Female sex was associated with an increased odds of a revisit for FNVD (odds, 1.94, p<0.001).

Conclusions: Significant disparities with respect to income and race exist in the incidence of revisits and potentially avoidable complications after adult tonsillectomy.