Factors Predictive of Adverse Postoperative Outcomes in Children Undergoing Tonsillectomy

Study Overview
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Brief Summary
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The purposes of the study are to identify 1) the patient (demographic and clinical) and health care system factors predictive of immediate and late postoperative adverse outcomes in children undergoing tonsillectomy. 2) Evaluate the preoperative use of the sleep questionnaire to identify children at risk for immediate and late postoperative adverse outcomes in children undergoing tonsillectomy.

Detailed Description
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Currently, children are scheduled to go home or stay in the hospital depending on expert consensus and institutional guidelines. The investigators preliminary experience (Dr. Sadhasivam PI: IRB No. 2008-0848) with the pharmocogenetic study, studying the phenotypic and genotypic influences of pain and use of opioids in patients undergoing tonsillectomy indicates that a significant number of patients scheduled as outpatients experience prolonged recovery phases in the PACU, some of whom are admitted or re-admitted following discharge. The identification of those factors that are, predictive of adverse events in tonsillectomy patients and the development of a prototype prediction model in this single-center study to support clinical decision-making. The rationale of this project is that developing a model to predict postoperative adverse events will not only lead to improved clinical outcomes and enhance patient safety, but also reduce family psychosocial distress associated with unanticipated hospital visits or re-admission, while reducing the burden on the health care system.

Official Title
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Factors Predictive of Adverse Postoperative Outcomes in Children Undergoing

Conditions
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Tonsillectomy Postoperative Adverse Events

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children 0-17 years of age Children scheduled for tonsillectomy or adeno-tonsillectomy ASA I, II, or III Exclusion Criteria: ASA IV and V

Ages Eligible for Study
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Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Emergency Room Admissions |  | Upto 3 weeks after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative Adverse Event | This will be measured in post anesthesia care unit (PACU) and will be a composite measure of any one or a combination of these: desaturation, somnolence, laryngospasm /airway obstruction, airway instrumentation, drug administration, PACU discharge criteria not met, unanticipated hospital or ICU admission. | Assessed in post anesthesia care unit | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Outcomes, Quality improvement, Patient Safety, PACU, Complications, Adverse events, Respiratory arrest, Pain, PONV, Age, Neonate, Infant, Child, Ambulatory, Inpatient, General Anesthesia, Otolaryngology, Tonsillectomy, Obstructive sleep apnea