Risk factors for adverse events in children with colds emerging from anesthesia: a logistic regression.
BACKGROUND
Recent upper respiratory infection (URI) in children increases respiratory adverse events following anesthesia for elective surgery. The increased risk continues weeks after resolution of acute URI symptoms. Few systematic analyses have explored specific risk factors. This logistic regression explores the relationship between preoperative URI symptoms and adverse events during emergence from anesthesia.


METHODS
Data were combined from control groups of several prospective observational and interventional studies in elective pediatric anesthesia in a tertiary care pediatric hospital. In each study, a blinded observer, distinct from the anesthesia care team, prospectively recorded the presence of stridor, oxygen desaturations (and their duration), coughing and laryngospasm. Parents were subsequently asked about the presence of 10 cold symptoms during the 6 weeks prior to operation.


RESULTS
Our model, based on a dataset of 335 patients, did not demonstrate an association between any particular symptoms and the rate of respiratory adverse events during emergence from anesthesia, with the exception of low-grade fever which appeared to be mildly protective. Respiratory adverse events were affected by the airway management technique (device used and timing of extubation), and adverse events were increased if peak URI symptoms had occurred within the preceding 4 weeks.


CONCLUSIONS
Specific preoperative symptoms were not useful in predicting respiratory adverse events during emergence from anesthesia.
Rachel Homer
J
J
Department of Anaesthesia, Aintree University Hospital, Liverpool, UK. rachelhomer@doctors.org.uk
Elwood
Tom
T
Peterson
Do
D
Rampersad
Sally
S
D000293:Adolescent; D000758:Anesthesia / Q000009:adverse effects*; D000762:Anesthesia Recovery Period; D002648:Child; D002675:Child, Preschool; D003139:Common Cold / Q000150:complications*; D003371:Cough / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007826:Laryngismus / Q000209:etiology; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012016:Reference Values; D012135:Respiratory Sounds / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects