Adenotonsillectomy for obstructive sleep apnea syndrome in young children: prevalence of pulmonary complications.
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.


METHODS
Retrospective analysis.


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


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


METHODS
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.
Statham
Melissa McCarty
MM
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Elluru
Ravindhra G
RG
Buncher
Ralph
R
Kalra
Maninder
M
D000233:Adenoidectomy; D000367:Age Factors; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D000768:Anesthesia, General; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012044:Regression Analysis; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D014068:Tonsillectomy