Overnight oximetry in children undergoing adenotonsillectomy: a single center experience
Abstract Background Obstructive sleep apnea (OSA) is the most common indication for adenotonsillectomy in children. Home-based sleep oximetry continues to be used in the diagnosis of pediatric OSA despite a lack of correlation with lab-based polysomnography. This study investigates whether factors i...
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SAGE Publishing
2019-12-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1186/s40463-019-0391-2 |
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| author | C. Carrie Liu Kathleen H. Chaput Valerie Kirk Warren Yunker |
| author_facet | C. Carrie Liu Kathleen H. Chaput Valerie Kirk Warren Yunker |
| author_sort | C. Carrie Liu |
| collection | DOAJ |
| description | Abstract Background Obstructive sleep apnea (OSA) is the most common indication for adenotonsillectomy in children. Home-based sleep oximetry continues to be used in the diagnosis of pediatric OSA despite a lack of correlation with lab-based polysomnography. This study investigates whether factors influence surgeons in selecting patients for home-based sleep oximetry, how the study findings are used in patient management, and whether abnormal oximetry findings are associated with post-operative complications. Methods A retrospective review was performed on children with suspected OSA who had undergone a tonsillectomy and/or an adenoidectomy over a three-year period. Demographic features, comorbidities, pre-operative oximetry results, and post-operative complications were recorded. Data analysis consisting primarily of logistic regression was performed using Stata 12.0 (College Station, Texas). Results Data was collected from 389 children. Two hundred and seventy-one children underwent pre-operative oximetry (69.7%). There was no significant association between age or the presence of comorbidities and the likelihood of undergoing pre-operative sleep oximetry. The post-operative complication rate was 0.8%. There was no significant association between abnormal sleep oximetry parameters and post-operative complications. Children with one or more abnormal sleep oximetry parameters were more likely to be observed in hospital for at least one night (OR 2.4, p < 0.0001). Conclusions Our study suggests that surgeons are using home-based sleep oximetry findings to inform the post-operative care of children with suspected OSA, as those with abnormal home-based sleep oximetry findings were more likely to be observed in hospital. These hospital admissions may be unnecessary given the poor correlation of home-based oximetry and PSG as well as the low rate of serious post-operative complications. |
| format | Article |
| id | doaj-art-e59157acb6004341ae5015ecab4266b8 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-e59157acb6004341ae5015ecab4266b82025-02-03T10:54:10ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162019-12-014811510.1186/s40463-019-0391-2Overnight oximetry in children undergoing adenotonsillectomy: a single center experienceC. Carrie Liu0Kathleen H. Chaput1Valerie Kirk2Warren Yunker3Sections of Otolaryngology - Head and Neck Surgery and Pediatric Surgery, Department of Surgery, Cumming School of Medicine, University of CalgaryDepartment of Obstetrics and Gynecology and Community Health Sciences, Cumming School of Medicine, University of CalgaryDivision of Pediatric Respirology, Cumming School of Medicine, University of CalgarySections of Otolaryngology - Head and Neck Surgery and Pediatric Surgery, Department of Surgery, Cumming School of Medicine, University of CalgaryAbstract Background Obstructive sleep apnea (OSA) is the most common indication for adenotonsillectomy in children. Home-based sleep oximetry continues to be used in the diagnosis of pediatric OSA despite a lack of correlation with lab-based polysomnography. This study investigates whether factors influence surgeons in selecting patients for home-based sleep oximetry, how the study findings are used in patient management, and whether abnormal oximetry findings are associated with post-operative complications. Methods A retrospective review was performed on children with suspected OSA who had undergone a tonsillectomy and/or an adenoidectomy over a three-year period. Demographic features, comorbidities, pre-operative oximetry results, and post-operative complications were recorded. Data analysis consisting primarily of logistic regression was performed using Stata 12.0 (College Station, Texas). Results Data was collected from 389 children. Two hundred and seventy-one children underwent pre-operative oximetry (69.7%). There was no significant association between age or the presence of comorbidities and the likelihood of undergoing pre-operative sleep oximetry. The post-operative complication rate was 0.8%. There was no significant association between abnormal sleep oximetry parameters and post-operative complications. Children with one or more abnormal sleep oximetry parameters were more likely to be observed in hospital for at least one night (OR 2.4, p < 0.0001). Conclusions Our study suggests that surgeons are using home-based sleep oximetry findings to inform the post-operative care of children with suspected OSA, as those with abnormal home-based sleep oximetry findings were more likely to be observed in hospital. These hospital admissions may be unnecessary given the poor correlation of home-based oximetry and PSG as well as the low rate of serious post-operative complications.https://doi.org/10.1186/s40463-019-0391-2Sleep oximetryObstructive sleep apneaSleep disordered breathing |
| spellingShingle | C. Carrie Liu Kathleen H. Chaput Valerie Kirk Warren Yunker Overnight oximetry in children undergoing adenotonsillectomy: a single center experience Journal of Otolaryngology - Head and Neck Surgery Sleep oximetry Obstructive sleep apnea Sleep disordered breathing |
| title | Overnight oximetry in children undergoing adenotonsillectomy: a single center experience |
| title_full | Overnight oximetry in children undergoing adenotonsillectomy: a single center experience |
| title_fullStr | Overnight oximetry in children undergoing adenotonsillectomy: a single center experience |
| title_full_unstemmed | Overnight oximetry in children undergoing adenotonsillectomy: a single center experience |
| title_short | Overnight oximetry in children undergoing adenotonsillectomy: a single center experience |
| title_sort | overnight oximetry in children undergoing adenotonsillectomy a single center experience |
| topic | Sleep oximetry Obstructive sleep apnea Sleep disordered breathing |
| url | https://doi.org/10.1186/s40463-019-0391-2 |
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