• Otolaryngol Head Neck Surg · Jun 2010

    Comparative Study

    Postoperative respiratory complications and recovery in obese children following adenotonsillectomy for sleep-disordered breathing: a case-control study.

    • Elaine Fung, Dominic Cave, Manisha Witmans, Kenton Gan, and Hamdy El-Hakim.
    • Pediatric Otolaryngology, Division of Pediatric Surgery, The Stollery Children's Hospital, Edmonton, Alberta, Canada. elainefung_1@yahoo.com
    • Otolaryngol Head Neck Surg. 2010 Jun 1;142(6):898-905.

    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.Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

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