OBJECTIVES

: With over 530,000 procedures performed yearly in the US, tonsillectomy and/or adenoidectomy procedures are the second most common ambulatory surgical procedures performed in children. These procedures have been associated with serious complications such as acute post-operative pain and hemorrhage, requiring readmission in the patient population <12 years. This study compared readmission rates and total procedure costs in patients following tonsillectomy/adenoidectomy procedures between Coblation technology and electrocautery.

METHODS

: Patients <12 years who underwent a primary tonsillectomy/adenoidectomy procedure were identified from the 2014-2016 Premier Hospital Healthcare database, using ICD 9/10 procedure codes: 28.2, 28.3, 28.6, 0CTQXZZ, 0CTQ0ZZ, 0CTP0ZZ, 0CTPXZZ, 0CTQ0ZZ and 0CTQXZZ. Patients who had a readmission due to hemorrhage or acute post-operative pain within 1 month post-operatively were identified based on ICD 9/10 codes: 998.11, J95.830, 338.18, or G89.18. Coblation technology and electrocautery treatment groups were created from this cohort. Multivariate regression analyses compared revision rates, departmental and total procedure costs between the 2 treatment groups, adjusting for covariates.

RESULTS

: A total of 7,562 patients met inclusion criteria, mean age (SD)= 5.5(2.6) years, male: 3,948(52.2%), white: 5,310(70.2%), number of comorbidities: ≤1= 7,547(99.8%), primary payers: Medicaid (48.98%) and Commercial (45.89%).By treatment group, 4,024(53.2%) and 3,538(46.8%) were treated with Coblation technology and electrocautery respectively. Logistic regression showed that readmission rates were comparable between the Coblation technology and electrocautery treatment groups; 2.0% and 2.1%; p=0.5953. A breakdown of procedure costs showed statistically significant lower costs for Coblation technology vs. electrocautery by: surgery ($1,009 vs. $1,162; p<0.0001) and pharmacy ($102.40 vs. $117.20; p<0.0001), respectively. However, Coblation technology compared to electrocautery had higher costs by central supply ($394.70 vs. 205.30; p<0.0001). A comparison of total costs showed that Coblation technology was slightly higher compared electrocautery ($2,646 vs. $2,591; difference=$55.94; p=0.0011).

CONCLUSIONS

: Coblation technology delivers comparable outcomes at near equal cost to electrocautery.