Perioperative Delta Weight and Pediatric Obstructive Sleep Apnea Resolution after Adenotonsillectomy.

Autor: Dang QL; Department of Otolaryngology, Head and Neck Surgery, Southwestern Medical Center at Dallas, University of Texas, Dallas, Texas, U.S.A., Ulualp S; Department of Otolaryngology, Head and Neck Surgery, Southwestern Medical Center at Dallas, University of Texas, Dallas, Texas, U.S.A., Mitchell RB; Department of Otolaryngology, Head and Neck Surgery, Southwestern Medical Center at Dallas, University of Texas, Dallas, Texas, U.S.A., Johnson RF; Department of Otolaryngology, Head and Neck Surgery, Southwestern Medical Center at Dallas, University of Texas, Dallas, Texas, U.S.A.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2024 Sep; Vol. 134 (9), pp. 4141-4147. Date of Electronic Publication: 2024 Mar 29.
DOI: 10.1002/lary.31417
Abstrakt: Objective(s): The first-line treatment for pediatric obstructive sleep apnea (OSA) is adenotonsillectomy. Post-operative weight gain is a well-documented phenomenon. We hypothesized that higher peri-adenotonsillectomy delta weight correlates with lower rates of OSA resolution in pediatric patients.
Methods: This was a retrospective cohort study consisting of 250 patients from 2 to 17 years of age at a tertiary academic medical center between January 2021 and December 2022. Polysomnography results and body mass index (BMI) changes were collected through the electronic health record. Univariate and multivariate logistical regression analyses were performed, adjusting for confounding factors.
Results: Perioperative delta weight and pre-operative baseline AHI values were significant predictors of residual OSA. For every 1-kilogram gain in weight, the odds of residual OSA (AHI >5) increase by 6.0% (OR = 1.06, 95% CI = 1.02-1.10, p < 0.002), and the odds of residual severe OSA (AHI > 10) increase by 8% (OR = 1.08, 95% CI = 1.04-1.12, p < 0.001). Increased AHI, Black/African American race, and male sex were also factors associated with incomplete OSA resolution.
Conclusions: Increased peri-adenotonsillectomy delta weight is associated with higher rates of residual OSA in children. Patients and families should be counseled about appropriate weight loss and control methods before adenotonsillectomy.
Level of Evidence: IV Laryngoscope, 134:4141-4147, 2024.
(© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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