A pilot study to identify pre- and peri-operative risk factors for airway complications following adenotonsillectomy for treatment of severe pediatric OSA

Abstract

Objective: A pilot study to identify risk factors predicting post-operative complications in children with severe OSA undergoing adenotonsillectomy. Methods: Retrospective review in a tertiary care academic institution. Two-stage least squares regression analysis and instrumental variable analysis to allow for modeling of pre- and peri-operative risk factors as having significance in predicting post-operative morbidity. Results: Eighty-three children (mean age 4.88 ± 3.09 years) with apnea-hypopnea index (AHI) ≥10 who were observed overnight following adenotonsillectomy were evaluated for rates of major (increased level of care, CPAP/BiPAP use, pulmonary edema and reintubation) and minor (oxygen saturation <90%) airway complications as well as total observation costs. Major and minor complications occurred in 4.8% and 19.3% of children, respectively. Age <2 years (p 24 (p <90% on room air in PACU (p 100 min (p