OBJECTIVE: To compare postoperative respiratory complications in obese and nonobese children following surgery for sleep-disordered breathing. STUDY DESIGN: Case-control study. SETTING: Pediatric tertiary care center. SUBJECTS AND METHODS: All obese children who had undergone adenotonsillectomy for sleep-disordered breathing from 2002 to 2007 were compared with age- and gender-matched controls. Subjects were identified from a prospective surgical database. Length of hospital stay and the incidence, severity, and location of respiratory complications were compared. Multivariable analysis was performed to identify predictive factors. RESULTS: Forty-nine obese children were identified (20:29, female:male). There were no differences in mean age or type of surgical procedures (P > 0.05). Overall, 37 obese children (75.5%) and 13 controls (26.5%) incurred complications (P = 0.000, OR 8.54 [95% CI 3.44-21.19]). Ten obese patients and two controls incurred major events (P = 0.012, OR 6.03 [95% CI 1.25-29.15]); 36 obese children had minor complications versus 12 controls (P = 0.000, OR 8.54 (95% CI 3.44-21.19). Obese children had significantly more upper airway obstruction (19 vs 4, P = 0.0003, OR 7.13 [95% CI 2.20-23.03]), particularly during the immediate postoperative period. The mean hospital stay was significantly longer for the obese group (18 vs 8 hours, P = 0.000, mean difference of 10 hours [95% CI 2.01-17.99]). Male gender, tonsillectomy, and body mass index were significant predictive factors. CONCLUSION: Obesity in children significantly increases the risk of respiratory complications following surgery for sleep-disordered breathing. Overnight hospitalization for obese children is recommended. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.
OBJECTIVE: To compare postoperative respiratory complications in obese and nonobese children following surgery for sleep-disordered breathing. STUDY DESIGN: Case-control study. SETTING: Pediatric tertiary care center. SUBJECTS AND METHODS: All obesechildren who had undergone adenotonsillectomy for sleep-disordered breathing from 2002 to 2007 were compared with age- and gender-matched controls. Subjects were identified from a prospective surgical database. Length of hospital stay and the incidence, severity, and location of respiratory complications were compared. Multivariable analysis was performed to identify predictive factors. RESULTS: Forty-nine obesechildren were identified (20:29, female:male). There were no differences in mean age or type of surgical procedures (P > 0.05). Overall, 37 obesechildren (75.5%) and 13 controls (26.5%) incurred complications (P = 0.000, OR 8.54 [95% CI 3.44-21.19]). Ten obesepatients and two controls incurred major events (P = 0.012, OR 6.03 [95% CI 1.25-29.15]); 36 obesechildren had minor complications versus 12 controls (P = 0.000, OR 8.54 (95% CI 3.44-21.19). Obesechildren had significantly more upper airway obstruction (19 vs 4, P = 0.0003, OR 7.13 [95% CI 2.20-23.03]), particularly during the immediate postoperative period. The mean hospital stay was significantly longer for the obese group (18 vs 8 hours, P = 0.000, mean difference of 10 hours [95% CI 2.01-17.99]). Male gender, tonsillectomy, and body mass index were significant predictive factors. CONCLUSION: Obesity in children significantly increases the risk of respiratory complications following surgery for sleep-disordered breathing. Overnight hospitalization for obesechildren is recommended. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.
Authors: Stephen J Gleich; Michael D Olson; Juraj Sprung; Toby N Weingarten; Darrell R Schroeder; David O Warner; Randall P Flick Journal: Paediatr Anaesth Date: 2012-07-09 Impact factor: 2.556
Authors: Roderick P Venekamp; Benjamin J Hearne; Deepak Chandrasekharan; Helen Blackshaw; Jerome Lim; Anne G M Schilder Journal: Cochrane Database Syst Rev Date: 2015-10-14