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Prevalence of Pulmonary Complications

Melissa McCarty Statham, MD; Ravindhra G. Elluru, MD, PhD; Ralph Buncher, ScD; Maninder Kalra, MD, MS

Arch Otolaryngol Head Neck Surg. 2006;132:476-480.

Objective  To determine, in a series of children younger than 6 years undergoing adenotonsillectomy for treatment of clinical obstructive sleep apnea syndrome (OSAS), the effect of age on prevalence of postoperative respiratory complications. The primary objective was to define a practice standard for postoperative hospital admission.

Design  Retrospective analysis.

Setting  Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Patients  All children younger than 6 years who underwent adenotonsillectomy to treat OSAS from June 1, 1999, to May 31, 2001.

Main Outcome Measures  The percentage of children younger than 3 years undergoing adenotonsillectomy to treat OSAS who experience a postoperative respiratory complication.

Results  Of 2315 patients younger than 6 years undergoing an adenotonsillectomy for treatment of OSAS, 149 (6.4%) developed a postoperative respiratory complication. Even though there was a lower incidence of comorbid medical conditions in this cohort, children younger than 3 years were at a greater risk for developing a postoperative respiratory complication compared with those aged 3 to 5 years (9.8% vs 4.9%, P<.001). Logistic regression analysis revealed that children younger than 3 years had a nearly 2-fold increased risk for respiratory complications postoperatively (odds ratio, 1.98; 95% confidence interval, 1.41-2.77) when controlling for race and sex.

Conclusions  Adenotonsillectomy to treat OSAS is associated with a significantly higher rate of postoperative respiratory complication in children younger than 3 years compared with children aged 3 to 5 years. Our results support hospital admission for all patients younger than 3 years undergoing adenotonsillectomy for treatment of OSAS.

Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Drs Statham and Elluru), Environmental Health (Mr Buncher), and Pediatrics (Dr Kalra), University of Cincinnati College of Medicine, Cincinnati, Ohio; and Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center (Dr Kalra).

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