Pediatric Postoperative Outcomes for Severe and Very Severe Obstructive Sleep Apnea Syndrome

被引:1
|
作者
Hurly, Jordyn A. [1 ]
Clements, Anna Christina [1 ]
Ryan, Marisa A. [2 ]
Ballard, Megan [2 ]
Jenks, Carolyn [2 ]
Sterni, Laura M. [3 ]
Tunkel, David E. [2 ]
Walsh, Jonathan M. [2 ,4 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Otolaryngol, Baltimore, MD 21218 USA
[2] Johns Hopkins Univ, Dept Otolaryngol Head & Neck Surg, Baltimore, MD 21218 USA
[3] Johns Hopkins Univ, Sch Med, Eudowood Div Pediat Resp Sci, Baltimore, MD USA
[4] 601 North Caroline St, Baltimore, MD 21287 USA
来源
LARYNGOSCOPE | 2024年 / 134卷 / 09期
关键词
adenotonsillectomy; obstructive sleep apnea; otolaryngology; postoperative complications; ADENOTONSILLECTOMY; CHILDREN; COMPLICATIONS;
D O I
10.1002/lary.31424
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objective: To determine if increasing obstructive sleep apnea syndrome (OSAS) severity, as determined by preoperative polysomnography data, is an independent risk for respiratory complications and level of follow-up care after adenotonsillectomy or tonsillectomy. Methods: A retrospective analysis of patients <= 21 years of age with severe OSAS (obstructive apnea-hypopnea index [OAHI] >10) undergoing adenotonsillectomy or tonsillectomy. Patients were categorized based on preoperative polysomnography data (PSG). Outcome measures including respiratory complications were collected via chart review. Logistic regression was used in the analysis of all parameters, and Wilcoxon Rank Sum tests were used for analysis of both OAHI and oxygen saturation nadir as continuous variables. All surgeries were performed at Johns Hopkins Hospital, a tertiary care center. Results: We identified 358 patients with severe OSAS who had adenotonsillectomy or tonsillectomy. OAHI >40 and oxygen saturation nadir <80% were significantly associated with postoperative respiratory complications. Increasing OAHI and O2 saturation <80% was each associated with unplanned continuous positive airway pressure (CPAP) initiations postoperatively. There was no association between hypercarbia and presence of any complications. Conclusion: Patients with very severe OSAS (preoperative OAHI >= 40) as determined by preoperative PSG may be at higher risk of developing respiratory complications postoperatively. However, there does not appear to be a linear association with increasing severity of OAHI on regression analysis. Further research is needed to understand factors associated with complications in severe and very severe OAHI.
引用
收藏
页码:4148 / 4155
页数:8
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