Postoperative respiratory complications and recovery in obese children following adenotonsillectomy for sleep‐disordered breathing: A case‐control study
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Medientyp:
E-Artikel
Titel:
Postoperative respiratory complications and recovery in obese children following adenotonsillectomy for sleep‐disordered breathing: A case‐control study
Erschienen in:
Otolaryngology–Head and Neck Surgery, 142 (2010) 6, Seite 898-905
Sprache:
Englisch
DOI:
10.1016/j.otohns.2010.02.012
ISSN:
0194-5998;
1097-6817
Entstehung:
Anmerkungen:
Beschreibung:
ObjectiveTo compare postoperative respiratory complications in obese and nonobese children following surgery for sleep‐disordered breathing.Study DesignCase‐control study.SettingPediatric tertiary care center.Subjects and MethodsAll 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.ResultsForty‐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.ConclusionObesity in children significantly increases the risk of respiratory complications following surgery for sleep‐disordered breathing. Overnight hospitalization for obese children is recommended.