Publication related to RSI or an RSI staff member
Predictors of postoperative respiratory complications in children undergoing adenotonsillectomy.
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is commonly treated with adenotonsillectomy (AT), bringing risk of perioperative respiratory adverse events (PRAEs). We aimed to concurrently identify clinical and polysomnographic predictors of PRAEs in children undergoing AT. METHODS: Retrospective study of children undergoing AT at a tertiary-care pediatric hospital, with prior in-hospital polysomnography, January 2010 to December 2016. PRAEs included those requiring oxygen, jaw thrust, positive airway pressure, or mechanical ventilation. Relationships of PRAEs to preoperative comorbidities or polysomnography results were examined with univariable logistic regression. Variables with P < .1 and age were included in backward stepwise multivariable logistic regression. Predictive performance (area under the curve, AUC) was validated with bootstrap resampling. RESULTS: Analysis included 374 children, median age 6.1 years; 286 (76.5%) had >/= 1 comorbidity. 344 (92.0%) had sleep-disordered breathing; 232 (62.0%) moderate-severe; 66 (17.6%) had >/= 1 PRAE. PRAEs were more frequent in children with craniofacial, genetic, cardiac, airway anomaly, or neurological conditions, AHI >/= 5 events/h and oxygen saturation nadir
Authors
- Katz, Sherri L, Katz SL, Children's Hospital of Eastern Ontario, Department of Pediatrics, Ottawa, Ontario, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.; University of Ottawa, School of Epidemiology and Public Health, Ottawa, Ontario, Canada.
- Monsour, Andrea, Monsour A, Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
- Barrowman, Nicholas, Barrowman N, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
- Hoey, Lynda, Hoey L, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
- Bromwich, Matthew, Bromwich M, Children's Hospital of Eastern Ontario, Department of Pediatrics, Ottawa, Ontario, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
- Momoli, Franco, Momoli F, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; University of Ottawa, School of Epidemiology and Public Health, Ottawa, Ontario, Canada.
- Chan, Theodora, Chan T, McMaster University, School of Physiotherapy, Hamilton, Ontario, Canada.
- Goldberg, Reuben, Goldberg R, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
- Patel, Abhilasha, Patel A, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
- Yin, Li, Yin L, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
- Murto, Kimmo, Murto K, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.; Children's Hospital of Eastern Ontario, Department of Anesthesia, Ottawa, Ontario, Canada.
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is commonly treated with adenotonsillectomy (AT), bringing risk of perioperative respiratory adverse events (PRAEs). We aimed to concurrently identify clinical and polysomnographic predictors of PRAEs in children undergoing AT. METHODS: Retrospective study of children undergoing AT at a tertiary-care pediatric hospital, with prior in-hospital polysomnography, January 2010 to December 2016. PRAEs included those requiring oxygen, jaw thrust, positive airway pressure, or mechanical ventilation. Relationships of PRAEs to preoperative comorbidities or polysomnography results were examined with univariable logistic regression. Variables with P < .1 and age were included in backward stepwise multivariable logistic regression. Predictive performance (area under the curve, AUC) was validated with bootstrap resampling. RESULTS: Analysis included 374 children, median age 6.1 years; 286 (76.5%) had >/= 1 comorbidity. 344 (92.0%) had sleep-disordered breathing; 232 (62.0%) moderate-severe; 66 (17.6%) had >/= 1 PRAE. PRAEs were more frequent in children with craniofacial, genetic, cardiac, airway anomaly, or neurological conditions, AHI >/= 5 events/h and oxygen saturation nadir
