{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:59:51Z","timestamp":1790816391958,"version":"4.1.0"},"reference-count":33,"publisher":"American Academy of Pediatrics (AAP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate postoperative disposition and resource use among patients admitted to the inpatient unit or pediatric intensive care unit (PICU) following tonsillectomy, adenoidectomy, and tonsillectomy\/adenoidectomy (T\/A).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>This retrospective cohort study featured patients aged 18\u00a0years or less after T\/A procedures in 38 children\u2019s hospitals in the Pediatric Health Information System database (2016\u20132023). Patients were categorized by postoperative disposition: ambulatory, inpatient unit, inpatient unit with subsequent PICU transfer, or PICU; inpatient admissions were analyzed. Primary outcomes were the frequency of urgent interventions (racemic epinephrine administration and noninvasive ventilation) and emergent interventions or outcomes (invasive mechanical ventilation, cardiopulmonary resuscitation, hemorrhage, blood transfusion, or return to operating room). The secondary outcome was median daily hospital cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 388\u2009071 T\/A procedures were identified, including 316\u2009323 ambulatory and 71\u2009748 inpatient. Among the patients in the inpatient unit and PICU, 2% and 16% received an urgent intervention, and, in both locations, 2% received an emergent intervention or outcome. For patients without interventions, the median daily cost difference between PICU and inpatient unit admissions was $1774. Based on the difference between PICU and inpatient costs for patients with no interventions, we estimate that $2.6 million could be saved if 50% of these patients in the PICU were admitted to the inpatient unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>A minority of PICU admissions following T\/A procedures require urgent or emergent interventions. This suggests that deimplementation of routine T\/A PICU admissions may facilitate transitioning patients to the inpatient unit, reducing costs and optimizing PICU use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2026-009276","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:02:59Z","timestamp":1786579379000},"page":"872-879","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Interventions and Cost Associated With Disposition After Tonsil and Adenoidectomy"],"prefix":"10.1542","volume":"16","author":[{"given":"Vanessa","family":"Toomey","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, USC Keck School of Medicine, University of Southern California, Los Angeles, California"},{"name":"2Department of Anesthesiology Critical Care Medicine, Children\u2019s Hospital Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia A.","family":"Heneghan","sequence":"additional","affiliation":[{"name":"3Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota M Health Fairview Masonic Children\u2019s Hospital, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Hall","sequence":"additional","affiliation":[{"name":"4Children\u2019s Hospital Association, Lenexa, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Kane","sequence":"additional","affiliation":[{"name":"5Department of Pediatrics, Endeavor Health, Evanston, Illinois and Pediatric Critical Care Medicine, Comer Children\u2019s Hospital, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin M.","family":"Rogerson","sequence":"additional","affiliation":[{"name":"6Division of Critical Care, Department of Pediatrics, IU School of Medicine, Indiana University, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie A.","family":"Dervan","sequence":"additional","affiliation":[{"name":"7Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, Washington"},{"name":"8Center for Clinical and Translational Research, Seattle Children\u2019s Research Institute, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam C.","family":"Dziorny","sequence":"additional","affiliation":[{"name":"9Division of Pediatric Critical Care, Department of Pediatrics, University of Rochester School of Medicine, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph G.","family":"Kohne","sequence":"additional","affiliation":[{"name":"10Division of Pediatric Critical Care Medicine, University Hospitals Rainbow Babies & Children\u2019s Hospital, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Roumeliotis","sequence":"additional","affiliation":[{"name":"11Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada"},{"name":"12CHU Sainte-Justine Research Center, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Garros","sequence":"additional","affiliation":[{"name":"13Division of Critical Care, Department of Pediatrics, Stollery Children\u2019s Hospital, University of Alberta Hospital, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Cecil","sequence":"additional","affiliation":[{"name":"14Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Goodman","sequence":"additional","affiliation":[{"name":"15Division of Pediatric Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. 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