Pediatric Adenoidectomy in the Very Young Child and Indications for Postoperative Inpatient Admission

Abstract Objectives To determine the rate of significant respiratory events following adenoidectomy in young patients and to identify factors that would prompt inpatient admission postoperatively. Methods A retrospective chart review was performed of consecutive adenoidectomy surgeries at a high-volume, tertiary-care children's hospital between 2016 and 2018. Children under 3.5 years of age who had surgery for obstructive symptoms were included. Patients were grouped by age (youngest ≤1.5 years, middle 1.6–2.5 years, and oldest 2.6–3.5 years). We excluded patients having revision surgery, a concomitant tonsillectomy, or additional major surgical procedure. Results There were 353 patients that met inclusion criteria. The three age groups were similar with respect to all characteristics except age (p  Conclusions Significant respiratory events are uncommon after adenoidectomy for obstructive symptoms, even in very young children. However, for children under 1.5 years of age or those with AHI scores above 5 events/hr, postoperative admission for monitoring is recommended. Clinical judgement should be used when considering outpatient surgery for older children or those with comorbidities.