Effect of Race, Ethnicity, and Language on Adenotonsillectomy Outcomes in Pediatric Otolaryngology.

Abstract

Objective: Disparities have been described across racial and socioeconomic groups in adenotonsillectomy access and surgical outcomes, but little is known about the impact of language. We studied the effect of race, ethnicity, and language on the frequency of postoperative rates of visits to the emergency department, hospital admissions, and return to the operating room. We hypothesized that non-white, Hispanic, and patients speaking a non-English language would have higher rates of emergency department visits, readmissions, and return to the operating room.

Study design: Retrospective cohort analysis.

Setting: Tertiary care academic center.

Methods: Demographic and encounter data were abstracted from the hospital's data warehouse for patients who underwent adenotonsillectomy over 12 years (May 2011-June 2023). Continuous variables were compared using the Kruskal-Wallis test or Mann-Whitney U test as indicated. Categorical variables were compared using Fisher's exact test.

Results: Our study included 7945 patients. Non-white patients had higher 30-day emergency department visit rates than white patients (8.6% vs 6.8%; P = .003) but comparable 30-day hospital admissions and 30-day return to the operating room rates. Hispanic and other ethnic groups had higher rates of postoperative emergency department visits (8.0%, 8.6%) compared to non-Hispanic white patients (6.8%; P = .026). Patients speaking Spanish or a different non-English language had higher 30-day emergency department visits (8.7%, 10.6%) than English-speaking patients (7.3%; P = .038). Rates of hospital admission and return to the operating room were similar across race and ethnic groups.

Conclusion: Higher rates of postoperative emergency department visits were present for our patient population across racial, ethnic, and linguistic cohorts.