Obesity and risk of peri-operative complications in children presenting for adenotonsillectomy.
BACKGROUND
Adenotonsillectomy (T&A) is a very common surgical procedure in children. With the rising prevalence of childhood overweight and obesity, our goal was to describe the prevalence of overweight/obesity in children presenting for T&A in our institution. We also sought to compare the frequency of peri-operative complications and the likelihood of being admitted following T&A between overweight/obese and normal weight children.


METHODS
We examined our peri-operative database and extracted clinical, demographic and anthropometric information on 2170 children who underwent T&A between January 2005 and February 2008. Children were classified into normal weight, overweight and obese using published body mass index (BMI) criteria. The incidences of peri-operative complications were compared between the BMI categories. We also examined factors contributing to the likelihood of admission following T&A.


RESULTS
The overall prevalence of overweight and obese was 20.7%. Overweight/obese children were more likely to have intra-operative desaturation (p=0.004), multiple attempts at laryngoscopy (p<0.001), difficult mask ventilation (p=0.001), and post-induction and post-anesthesia care unit (PACU) upper airway obstruction (p<0.001). Additionally, overweight and obese children were more likely to be admitted following T&A. BMI showed a moderate positive correlation with post-operative length of stay (LOS). Multiple logistic regression analysis showed that BMI and presence of medical co-morbidities were independent predictors of LOS.


CONCLUSIONS
Overweight and obese children presenting for T&A have a higher incidence of peri-operative complications and are more likely to be admitted and stay for longer than their healthy weight peers.
Nafiu
Olubukola O
OO
Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA. onafiu@med.umich.edu
Green
Glenn E
GE
Walton
Sarah
S
Morris
Michelle
M
Reddy
Sudheera
S
Tremper
Kevin K
KK
D000233:Adenoidectomy; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007828:Laryngoscopy; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D014068:Tonsillectomy; D014069:Tonsillitis / Q000150:complications / Q000453:epidemiology / Q000601:surgery