title: African American ethnicity as a risk factor for respiratory complications following adenotonsillectomy.
abstract: OBJECTIVE
  To evaluate whether African American ethnicity is a risk factor for major respiratory complications following adenotonsillectomy (T&A).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A Canadian tertiary care center. PATIENTS Children aged 0 to 18 years who underwent T&A at our institution from 2002 to 2006 with planned or unplanned postoperative admissions.
  
  
  METHODS
  We evaluated the association between ethnicity and our main outcome measure, major perioperative respiratory complications of T&A. Parental report of ethnicity was available for 23% of our cohort. At our institution, African American children undergo a routine preoperative sickle cell test (TestSC). Data on TestSC were included for all children. We established that having a TestSC was an accurate proxy for African American ethnicity (sensitivity, 96%; specificity, 93%; positive predictive value, 77%; negative predictive value, 99%).
  
  
  RESULTS
  Seventy-four of 594 children experienced major respiratory complications (12.5%). Compared with children who did not have major respiratory complications, those who did had a TestSC (P = .01), were 2 years or younger (P < .001) and had lower weight-for-age z scores (P = .04), moderate to severe obstructive sleep apnea (P = .003), and comorbidities (P < .001). When controlling for these variables in a multivariate analysis, children of African American ethnicity (TestSC used as a proxy) were at higher risk of having major perioperative respiratory complications (adjusted odds ratio, 1.82 [95% CI 1.05-3.14]) (P = .003).
  
  
  CONCLUSIONS
  Children of African American ethnicity (TestSC used as a proxy) are nearly twice as likely to experience major respiratory complications related to T&A. Ethnicity may be an additional independent risk factor for clinicians to consider when planning for T&A.
authors: Departments of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Canada.
authors: Linda
authors: L
authors: Horwood
authors: Lily H P
authors: LH
authors: Nguyen
authors: Karen
authors: K
authors: Brown
authors: Philippe
authors: P
authors: Paci
authors: Evelyn
authors: E
authors: Constantin
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects*; D000367:Age Factors; D000402:Airway Obstruction / Q000628:therapy; D044383:Black People / Q000706:statistics & numerical data*; D001835:Body Weight; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D004232:Diuretics / Q000627:therapeutic use; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D009292:Narcotic Antagonists / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D056888:Patient Positioning; D011237:Predictive Value of Tests; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000601:surgery; D014068:Tonsillectomy / Q000009:adverse effects*; D001741:Black or African American
chemical_list: D001993:Bronchodilator Agents; D004232:Diuretics; D009292:Narcotic Antagonists