Apnea-hypopnea index severity as an independent predictor of post-tonsillectomy respiratory complications in pediatric patients: A retrospective study.

Autor:	Rossi NA; Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA., Spaude J; School of Medicine, University of Texas Medical Branch, Galveston, TX, USA., Ohlstein JF; Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA., Pine HS; Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA., Daram S; Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA., McKinnon BJ; Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA., Szeremeta W; Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA.
Jazyk:	angličtina
Zdroj:	Ear, nose, & throat journal [Ear Nose Throat J] 2024 Jul; Vol. 103 (7), pp. 424-429. Date of Electronic Publication: 2021 Dec 01.
DOI:	10.1177/01455613211059468
Abstrakt:	Introduction: Despite the presence of clinical practice guidelines for overnight admission of pediatric patients following adenotonsillectomy, variance in practice patterns exists between pediatric otolaryngologists. The purpose of this study is to examine severity of apnea-hypopnea index (AHI) as an independent predictor of postoperative respiratory complications in children undergoing adenotonsillectomy. Methods: Retrospective chart review of all children undergoing adenotonsillectomy at a large tertiary referral center between January 2015 and December 2019 who underwent preoperative polysomnography and were admitted for overnight observation. Charts were reviewed for total adverse events and respiratory events occurring during admission. Results: Overall, respiratory events were seen in 50.6% of patients with AHI ≥10 and in 39.6% of patients with AHI <10. The overall mean AHI was 19.2, with a mean of 28.1 in the AHI ≥10 subgroup vs 4.6 in the AHI <10 subgroup. There was no statistical correlation or increased risk between an AHI ≥10 and having a pure respiratory event, with a relative risk of 1.19 (.77-1.83, P = .43). There was a statistically significant difference between the mean AHI of those with any adverse event and those without (21.6 vs 13.4, P = .008). There is additionally an increased risk of any event with an AHI over 10, with a relative risk of 1.51 (1.22-1.88, P < .0001). Conclusion: Preoperative AHI of 10 events per hour was not a predictor of postoperative respiratory complications. However, there was a trend for those with a higher AHI requiring additional supportive measures or a prolonged stay. Practitioners should always use their best judgment in deciding whether a child warrants postoperative admission following adenotonsillectomy. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu