Overnight oximetry in children undergoing adenotonsillectomy: a single center experience.

TitleOvernight oximetry in children undergoing adenotonsillectomy: a single center experience.
Publication TypeJournal Article
Year of Publication2019
AuthorsC Liu C, Chaput KH, Kirk V, Yunker W
JournalJ Otolaryngol Head Neck Surg
Date Published2019 Dec 03
KeywordsAdenoidectomy, Adolescent, Child, Child, Preschool, Female, Humans, Infant, Male, Oximetry, Polysomnography, Preoperative Period, Reproducibility of Results, Retrospective Studies, Sleep Apnea, Obstructive, Tonsillectomy

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.

Alternate JournalJ Otolaryngol Head Neck Surg
PubMed ID31796111
PubMed Central IDPMC6888940
Faculty Reference: 
Che Carrie Liu, MD, MPH