Impact of ASA and Body Mass Index in Pediatric Tonsillectomy

Abstract

Objective: To identify the impact of body mass index and ASA classification on complications, PICU stay and length of hospitalization following tonsillectomy. Method: Retrospective chart review of all tonsillectomies performed from July 2008 to December 2009 at a tertiary pediatric institution, including BMI, length of stay, length of intubation, ASA status, hemorrhage, and PICU stay. Results: A total of 677 patients were identified, with complete data in 607, 4.4% underweight, 49% normal, 45% overweight or obese. No significance difference between BMI categories for hospitalization, length of intubation or postoperative hemorrhage, or between ASA for hemorrhage or length of intubation. BMI normal to obese ( P = .0006) and overweight to obese patients ( P = .0253) showed significant difference in PICU stay. ASA classification showed significant difference in length of hospitalization in ASA 1 and 2 ( P < .001), 2 and 3 ( P = .0002), and 1 and 3 ( P = .0002), and in PICU stay between ASA 1 and 3 ( P < .0001), 1 and 2 ( P = .0095) and 2 and 3 ( P < .0001). Conclusion: Overweight and obese patients are a significant percentage of patients undergoing tonsillectomies in this country. Patients with higher ASA status (2 and 3) show higher use of PICU resources and longer hospitalizations, and patients of overweight and obese categories require PICU care more often than patients with normal weight.