Comparison of Tonsillectomy Complication Rates in a Global Underserved Community to Those of a Tertiary Medical CenterIntroduction Understanding surgical outcomes in diverse settings is crucial for safe delivery of healthcare to underserved communities. Insufficient research has been done analyzing postoperative complications in regions with limited access to healthcare resources.
Objective To compare postoperative complications from tonsillectomies and adenoidectomies on global health trips to an underserved community to those of a tertiary academic medical center (TAMC).
Methods Data was collected via phone survey with patients from 2 2023 surgical trips to Azua, in the Dominican Republic (DR), sponsored by a TAMC, including surgery type, postoperative healthcare visits, and postoperative complications. The same data was collected via retrospective chart review from patients at a TAMC in 2023. The surgeries included were tonsillectomy adenoidectomy (T&A), tonsillectomy (T), and adenoidectomy (A). A statistical analysis compared non-routine healthcare visits and postoperative complications between populations using the Fisher's exact test.
Results In the DR, 168 patients (mean age: 8 years) underwent T&A (n = 113), T (n = 34), and A (n = 21). At the TAMC, 520 patients (mean age: 7.8 years) underwent T&A (n = 288), T (n = 123), and A (n = 109). No patients from the DR reported postoperative bleeding within 2 weeks of surgery, compared to 23 patients from the TAMC (p < 0.001). There was no statistical difference in trouble swallowing and uncontrolled pain within 2 weeks between the populations (p = 0.673 and 0.465).
Conclusion The T&A procedures on global health trips to underserved communities were not associated with increased rates of life-threatening complications compared with a TAMC. Surgical trips can provide safe and effective otolaryngologic care to patients in underserved communities.
Keywords
tonsillectomy; adenoidectomy; postoperative complications; surgical trip; global health