TY - JOUR
T1 - Complications of adenotonsillectomy for obstructive sleep apnea in school-aged children
AU - Konstantinopoulou, Sofia
AU - Gallagher, Paul
AU - Elden, Lisa
AU - Garetz, Susan L.
AU - Mitchell, Ron B.
AU - Redline, Susan
AU - Rosen, Carol L.
AU - Katz, Eliot S.
AU - Chervin, Ronald D.
AU - Amin, Raouf
AU - Arens, Raanan
AU - Paruthi, Shalini
AU - Marcus, Carole L.
N1 - Funding Information:
This study was supported by grants ( HL083075 , HL083129 , UL1 RR024134 , and UL1 RR024989 ) from the National Institutes of Health .
Funding Information:
Dr. Marcus reports receiving a loan of research equipment from Philips Respironics and Ventus Medical. Dr. Redline received a grant from ResMed Foundation and ResMed Inc and equipment for use in research from ResMed Inc and Philips Respironics. Dr. Chervin reports serving as a board member for the American Academy of Sleep Medicine, American Sleep Medicine Foundation, American Board of Sleep Medicine, Association Professional Sleep Societies, International Pediatric Sleep Association, and Sweet Dreamzzz; receiving consulting fees from Procter & Gamble, MC3, and Zansors; having patents, patents pending, and copyrighted material, owned by his institution, for assessment and treatment of sleep disorders; receiving royalties from Up-to-date and Cambridge University Press; and receiving gifts to his institution for educational purposes from Philips Respironics and Fisher and Paykel. Dr. Shalini Paruthi has no conflicts of interest but she reports royalties from Up-to-date for writing on obstructive sleep apnea. No other potential conflicts of interest relevant to this article were reported.
Publisher Copyright:
© 2014 Elsevier Ireland Ltd.
PY - 2015
Y1 - 2015
N2 - Introduction: Adenotonsillectomy is the treatment of choice for most children with obstructive sleep apnea syndrome, but can lead to complications. Current guidelines recommend that high-risk children be hospitalized after adenotonsillectomy, but it is unclear which otherwise-healthy children will develop post-operative complications. We hypothesized that polysomnographic parameters would predict post-operative complications in children who participated in the Childhood AdenoTonsillectomy (CHAT) study. Methods: Children in the CHAT study aged 5-9 years with apnea hypopnea index 2-30/h or obstructive apnea index 1-20/h without comorbidities other than obesity/asthma underwent adenotonsillectomy. Associations between demographic variables and surgical complications were examined with Chi square and Fisher's exact tests. Polysomnographic parameters between subjects with/without complications were compared using Mann-Whitney tests. Results: Of the 221 children (median apnea hypopnea index 4.7/h, range 1.2-27.7/h; 31% obese), 16 (7%) children experienced complications. 3 (1.4%) children had respiratory complications including pulmonary edema, hypoxemia and bronchospasm. Thirteen (5.9%) had non-respiratory complications, including dehydration (4.5%), hemorrhage (2.3%) and fever (0.5%). There were no statistically significant associations between demographic parameters (gender, race, and obesity) or polysomnographic parameters (apnea hypopnea index, % total sleep time with SpO2<92%, SpO2 nadir, % sleep time with end-tidal CO2>50Torr) and complications. Conclusions: This study showed a low risk of post-adenotonsillectomy complications in school-aged healthy children with obstructive apnea although many children met published criteria for admission due to obesity, or polysomnographic severity. In this specific population, none of the polysomnographic or demographic parameters predicted post-operative complications. Further research could identify the patients at greatest risk of post-operative complications.
AB - Introduction: Adenotonsillectomy is the treatment of choice for most children with obstructive sleep apnea syndrome, but can lead to complications. Current guidelines recommend that high-risk children be hospitalized after adenotonsillectomy, but it is unclear which otherwise-healthy children will develop post-operative complications. We hypothesized that polysomnographic parameters would predict post-operative complications in children who participated in the Childhood AdenoTonsillectomy (CHAT) study. Methods: Children in the CHAT study aged 5-9 years with apnea hypopnea index 2-30/h or obstructive apnea index 1-20/h without comorbidities other than obesity/asthma underwent adenotonsillectomy. Associations between demographic variables and surgical complications were examined with Chi square and Fisher's exact tests. Polysomnographic parameters between subjects with/without complications were compared using Mann-Whitney tests. Results: Of the 221 children (median apnea hypopnea index 4.7/h, range 1.2-27.7/h; 31% obese), 16 (7%) children experienced complications. 3 (1.4%) children had respiratory complications including pulmonary edema, hypoxemia and bronchospasm. Thirteen (5.9%) had non-respiratory complications, including dehydration (4.5%), hemorrhage (2.3%) and fever (0.5%). There were no statistically significant associations between demographic parameters (gender, race, and obesity) or polysomnographic parameters (apnea hypopnea index, % total sleep time with SpO2<92%, SpO2 nadir, % sleep time with end-tidal CO2>50Torr) and complications. Conclusions: This study showed a low risk of post-adenotonsillectomy complications in school-aged healthy children with obstructive apnea although many children met published criteria for admission due to obesity, or polysomnographic severity. In this specific population, none of the polysomnographic or demographic parameters predicted post-operative complications. Further research could identify the patients at greatest risk of post-operative complications.
KW - Adenotonsillectomy
KW - Childhood AdenoTonsillectomy study
KW - Obstructive sleep apnea syndrome
KW - Polysomnography
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U2 - 10.1016/j.ijporl.2014.12.018
DO - 10.1016/j.ijporl.2014.12.018
M3 - Article
C2 - 25575425
AN - SCOPUS:84922653781
SN - 0165-5876
VL - 79
SP - 240
EP - 245
JO - International Journal of Pediatric Otorhinolaryngology
JF - International Journal of Pediatric Otorhinolaryngology
IS - 2
ER -
