Evidence map›Paper›PMID 33150974›Full record

ArticleThe Laryngoscope2021

Detection of Respiratory Pathogens Does Not Predict Risks After Outpatient Adenotonsillectomy.

Donald M Vickers, Arundathi Reddy, Chary Akmyradov, Kesley M Brown, Bobby L Boyanton, Heather D Wright, Jay A Taylor, Sherry H Childress, Larry D Hartzell, Adam B Johnson and 5 more

Open access · hybridAbstract read
In one paragraph

Article in The Laryngoscope, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Donald M VickersOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Arundathi ReddyPediatric Otolaryngology, Anesthesiology, Pathology and Laboratory Medicine, Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
Chary AkmyradovCenter for Pediatric Translational Research Biostatistics, Arkansas Children's Research Institute, Little Rock, Arkansas, U.S.A.
Kesley M BrownOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Bobby L BoyantonOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Heather D WrightPediatric Otolaryngology, Anesthesiology, Pathology and Laboratory Medicine, Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
Jay A TaylorPediatric Otolaryngology, Anesthesiology, Pathology and Laboratory Medicine, Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
Sherry H ChildressPediatric Otolaryngology, Anesthesiology, Pathology and Laboratory Medicine, Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
Larry D HartzellOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Adam B JohnsonOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
James M KeyOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Abby R NolderOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Gresham T RichterOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Andre' M WinelandOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.ORCID 0000-0002-1576-3380
Graham M StrubOtolaryngology-Head and Neck Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.ORCID 0000-0002-2585-4956
Arkansas Children's Hospital · USUniversity of Arkansas for Medical Sciences · US

Funding

Arkansas ECHO ISPCTN Site (AREIS)UG1OD024945 · OD · ARKANSAS CHILDREN'S HOSPITAL RES INST · PI Stacie M Jones, Tamara Taylor Perry · 2016 to 2026
$4.3M
National Institute of Child Health and Human Development UG1OD024945NIH HHS UG1 OD024945
6 · The paper itself

Abstract

objectives/hypothesisTo determine whether the presence of detectable upper respiratory infections (URIs) at the time of adenoidectomy/adenotonsillectomy is associated with increased morbidity, complications, and unexpected admissions. STUDY

designProspective double-blinded cohort.

methodsIn this prospective cohort study, nasopharyngeal swabs were obtained intraoperatively from 164 pediatric patients undergoing outpatient adenoidectomy/tonsillectomy with or without pressure equalization tubes (PETs) and were analyzed with PCR for the presence of 22 known URIs, including SARS-CoV-2. Surgeons and families were blinded to the results. At the conclusion of the study, rates of detectable infection were determined and intraoperative and postoperative events (unexpected admissions, length of PACU stay, rates of laryngospasm/bronchospasm, oxygen desaturation, bradycardia, and postoperative presentation to an emergency department) were compared between infected and uninfected patients.

resultsOf the 164 patients (50% male, 50% female, ages 8 mo-18 y), 136 patients (82.9%) tested positive for one or more URI at the time of surgery. Forty one patients (25.0%) tested positive for three or more URIs concurrently, and 11 (6.7%) tested positive for five or more URIs concurrently. There were no significant differences in admission rates, length of PACU stay, rates of laryngospasm/bronchospasm, oxygen desaturation, bradycardia, or postoperative presentation to an emergency department between positive and negative patients. No patients tested positive for SARS-CoV-2.

conclusionsA recent positive URI test does not confer any additional intraoperative or postoperative risk in the setting of outpatient adenoidectomy/tonsillectomy in healthy patients. There is no utility in preoperative URI testing, and delaying surgery due to a recent positive URI test is not warranted in this population. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2074-E2079, 2021.

Indexed as

AdenoidectomyAir MicrobiologyAmbulatory Surgical ProceduresTonsillectomyAdolescentChildChild, PreschoolCohort StudiesDouble-Blind MethodFemaleHumansInfantMaleNasopharynxProspective StudiesRespiratory Tract Infectionsadenoidectomyoutpatient surgerytonsillectomyUpper respiratory pathogen testing

Identifiers

PMID33150974
PMCPMC8246986
OpenAlexW3095665888

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.