Predictors of OSA following adenotonsillectomy in children with trisomy 21.
OSA severity
adenotonsillectomy
down syndrome
obstructive sleep apnoea
paediatric
persistent
trisomy 21
Journal
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
ISSN: 1749-4486
Titre abrégé: Clin Otolaryngol
Pays: England
ID NLM: 101247023
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
27
07
2020
revised:
24
08
2020
accepted:
20
09
2020
pubmed:
16
10
2020
medline:
28
12
2021
entrez:
15
10
2020
Statut:
ppublish
Résumé
Given that 30%-50% of children with trisomy 21 have persistent obstructive sleep apnoea (OSA) after adenotonsillectomy, we evaluated whether demographic, clinical and polysomnographic factors predicted persistent OSA and OSA severity after adenotonsillectomy. Retrospective study. Secondary care hospital. Retrospective review of 32 children with the diagnosis of trisomy 21 and OSA by polysomnography who underwent adenotonsillectomy, from January 2010 to December 2018. Non-parametric analysis was used to compare pre- and postoperative factors, and regression was used to model persistent OSA and OSA severity. Thirty-two children were included (17 males, median age 10.00 ± 8.00 years, median body mass index z-score 0.89 ± 1.25). Overall, adenotonsillectomy resulted in a significant improvement in median obstructive apnoea-hypopnoea index (oAHI) from 7.5 ± 8.95 to 4.40 ± 4.38 events per hour (P < .001) and in median OSA-18 score from 85.00 ± 12.00 to 61.00 ± 37.75 (P < .001). Persistent OSA was found in 56.25% of the children. Univariate regression suggests that postoperative OSA-18 score was associated with persistent OSA after adenotonsillectomy. Preoperative oAHI, preoperative oxygen desaturation index, pre- and postoperative OSA-18 scores correlated with OSA severity after adenotonsillectomy. However, in a multivariate model only the postoperative OSA-18 score correlated with OSA severity after adenotonsillectomy. Although adenotonsillectomy results in a significant improvement of OSA in children with trisomy 21, more than half of the children had persistent OSA. The postoperative OSA-18 score was associated both with persistent OSA and OSA severity after adenotonsillectomy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
256-262Informations de copyright
© 2020 John Wiley & Sons Ltd.
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