Children who have developmental delays may be at greater risk for complications after a tonsillectomy, researchers report.
“This elevated risk of complications should be included in pre-operative counseling and has potential implications for pre-operative decision making and treatment plans in this high-risk population,” said Dr. Anthony Sheyn, chief of otolaryngology at Le Bonheur Children's Hospital in Memphis, Tenn.
“We suggest in-depth counseling and close follow-up after surgery for these patients to help reduce the current findings of an increased complication rate,” he explained in a hospital news release.
Developmental delay is a broad group of conditions involving impairments in communication, motor skills, problem solving and social interactions. Children with developmental delay often have complex medical histories and other health issues.
“We have a limited amount of literature studying the effect of [developmental delay] in pediatric surgical patients,” Sheyn said. “We wanted to further investigate the role that [developmental delay] has on the outcome of our most performed pediatric surgery, tonsillectomy.”
For the study, his team reviewed chart data from 400 tonsillectomy patients, comparing post-operative complication rates between children with and without developmental delay. About 14% of the patients had a developmental delay diagnosis.
The patients with developmental delay experienced significantly more respiratory complications, such as respiratory arrest and lower-than-normal oxygen levels overnight.
About 32% of patients with developmental delay had a complication after surgery, compared to 9% of patients without developmental delay, the investigators found. Other complications included hemorrhage, dehydration and vomiting.
Patients with moderate-to-severe developmental delay had a higher risk of complications than those with mild developmental delay, the study authors noted.
Patients with Down syndrome, global developmental delay or two or more delays in developmental milestones were classified as severe. About 69% of patients in the severe subgroup had a complication after surgery.
The researchers said the need for pre-operative planning is heightened for those with moderate-to-severe developmental delay.
The findings were recently published in the International Journal of Pediatric Otorhinolaryngology.
The U.S. Centers for Disease Control and Prevention has more on developmental disabilities.
SOURCE: Le Bonheur Children's Hospital, news release, March 2, 2023