Key result
Male sex is linked to ~4-fold higher odds of 30-day readmission after paediatric tonsillectomy.
Why the study?
Post-tonsillectomy readmission is an important indicator of paediatric surgical safety, but evidence regarding readmission rates and clinical predictors from resource-limited settings such as Libya remained limited.
What are the incidence and clinical predictors of 30-day hospital readmission in children undergoing tonsillectomy in a low-resource setting?
Observational (n=291)
Yes
What are the incidence and clinical predictors of 30-day hospital readmission in children undergoing tonsillectomy in a low-resource setting?
Answers are grounded in this paper and cite their sources.
In a Libyan multicentre cohort of paediatric tonsillectomy patients, 30-day readmission occurred in 9.3% of children—driven primarily by haemorrhage and poor oral intake—with male sex and recurrent tonsillitis increasing risk and dual-agent analgesia reducing risk.
BACKGROUND Post-tonsillectomy readmission is an important indicator of paediatric surgical safety, but evidence from resource-limited settings remains limited. This study investigated the rates and clinical predictors of readmission in Libya. These findings establish critical perioperative quality indicators to inform local discharge strategies and improve surgical safety in fragile health systems. MATERIAL AND METHODS A prospective multicentre observational study was conducted in five Libyan hospitals between 15 August 2025 and 1 August 2026. Children undergoing tonsillectomy, with or without concurrent procedures, were followed for 30 days after discharge through outpatient visits and structured telephone interviews. Demographic, clinical, laboratory, operative, and postoperative data were collected. Associations with readmission were assessed using non-parametric tests, followed by binary logistic regression. RESULTS Among 291 children, the median age was 7 years (interquartile range, 5-10), and 169 (58.1%) were female. Twenty-seven patients were readmitted within 30 days, giving a readmission rate of 9.3%. Postoperative haemorrhage was the most common cause of readmission (13 patients, 48.1% of readmitted cases), followed by poor oral intake (11 patients, 40.7% of readmitted cases). Male sex was associated with increased odds of readmission (odds ratio, 3.96; 95% CI, 1.59-9.89; P = 0.003), as was recurrent tonsillitis compared with obstructive sleep disordered breathing (odds ratio, 3.54; 95% CI, 1.37-9.11; P = 0.009). Dual analgesia was associated with lower odds of readmission (odds ratio, 0.23; 95% CI, 0.06-0.84; P = 0.02). CONCLUSION The 30-day readmission rate was 9.3%. Haemorrhage and poor oral intake were the leading causes. Male sex and recurrent tonsillitis were associated with increased odds of readmission, whereas dual-agent postoperative analgesia was associated with a reduced readmission risk. Evaluating these clinical patterns may help inform risk stratification and guide post-discharge strategies in similar clinical settings. Larger studies with standardised outcome assessment and centre-adjusted analyses are warranted.
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Fadallah et al. (2026) conducted an observational in Paediatric tonsillectomy (n=291). Male sex, recurrent tonsillitis, and dual-agent postoperative analgesia vs. Female sex, obstructive sleep disordered breathing, and non-dual analgesia was evaluated on 30-day hospital readmission following paediatric tonsillectomy (OR 3.96, 95% CI 1.59-9.89, p=0.003). Paediatric tonsillectomy had a 9.3% 30-day readmission rate; male sex (OR 3.96, P=0.003) and recurrent tonsillitis (OR 3.54, P=0.009) increased odds, while dual analgesia reduced odds (OR 0.23, P=0.02).
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