Sleep apnea in children and the risk of unexpected post-surgery admissions for nonotolaryngologic surgery.

Abstract

The purposes of this study were to access the prevalence of obstructive sleep apnea (OSA) in pediatric patients receiving nonotolaryngo-logic ambulatory surgery and to evaluate the probable association of OSA with the unexpected post-surgery hospital admission of these patients. As a retrospective cohort study data was gathered from the Pediatric Health Information System (PAIS) beginning January 1, 2010 and ending August 31, 2022. The patient population for the study included children less than 18 years old, who had nonotolaryngologic ambulatory surgery, with unexpected admissions which were described as equal or greater than one day of postoperative stay. Patients excluded from the study had diagnoses of sleep disordered breathing, cleft lip or palate needing repair, and snoring. Pediatric patients included in the study totaled 855,832 with 63 percent reported as male. For children diagnosed with OSA having unexpected post non-otolaryngologic surgery admissions 43.3 percent were ages six to 12 years, 35 percent were two to five years and 21.7 percent were equal or greater than 13 years. Study group findings recorded that 39,467 (4.6 percent) of the total children in the study experienced unexpected post-surgery admissions. From this total, 599 (4.0 percent) of the children had evidence of OSA, and needed unexpected post-surgery admission, while 38,828 (5.0 percent) had no evidence of OSA. Of the children with evidence of OSA, 544 (9.4 percent) had a known diagnosis of OSA. The odds risk for unexpected post-surgery admission for children with OSA was 2.56 times that of those without OSA (95%, CI 1.32-2.83; P<.001), this finding presented OSA as a significant risk factor. Also, over the time of the study there had been a less than four-fold increase of 0.4 percent in 2010 to 1.7 percent in 2022 (P trends <.001) in the number of children with OSA requiring unexpected post-surgery admissions after nonotolaryngologic ambulatory surgery. Knowledge of this information should help in patient selection for ambulatory surgery, decrease unexpected post-surgery admissions, increase family and patient satisfaction and patient safety and decrease the use and cost of healthcare resources.