Clinical Prediction Rules, Adenotonsillectomy and Children With Obstructive Sleep Apnea: What's Next?

Murto, Kimmo

doi:10.5664/jcsm.6826

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…It is possible that children's patterns of intraoperative and postoperative sentinel respiratory events also need to be considered to better predict significant PRAEs. 36…”

Section: Discussionmentioning

confidence: 99%

Predictors of postoperative respiratory complications in children undergoing adenotonsillectomy

Katz

Monsour

Barrowman

et al. 2020

Journal of Clinical Sleep Medicine

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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 ≤ 80% on preoperative polysomnography. Prediction modeling identified cardiac comorbidity (odds ratio [OR] 2.09

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“…It is possible that children's patterns of intraoperative and postoperative sentinel respiratory events also need to be considered to better predict significant PRAEs. 36…”

Section: Discussionmentioning

confidence: 99%