Predictors of obtaining polysomnography among otolaryngologists prior to adenotonsillectomy for childhood sleep-disordered breathing

Derek J. Lam, Steven A. Shea, Edward M. Weaver, Ron B. Mitchell

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Study Objectives: (1) To assess the predictors for obtaining polysomnography (PSG) in children undergoing adenotonsillectomy (AT) for sleep-disordered breathing, and (2) to estimate the adherence to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guideline recommendations for pre-AT PSG. Methods: This was a retrospective cohort study of children who were seen in the Pediatric Otolaryngology Clinic and underwent AT for sleep-disordered breathing over a 13-month period at a single tertiary care children’s hospital. Patients with and without pre-AT PSG were compared using bivariate and logistic regression analysis to identify predictors for PSG. Electronic medical records were reviewed for demographic variables, medical comorbidities, and PSG data. Adherence to AAO-HNS guideline recommendations was estimated by calculating the proportion of patients who had a PSG among those who met the recommended criteria for pre-AT PSG. Results: Mean age was 6.6 ± 3.6 years with 53% male. A total of 65 of 324 children (20%) underwent PSG prior to AT. The only factor significantly associated with pre-AT PSG was age 1 to 3 years (odds ratio 4.5, 95% confidence interval [2.2, 9.0], P < .001). Among patients who met AAO-HNS criteria for pre-AT PSG, 28 of 128 (20%) underwent PSG compared to 35 of 186 (19%) who did not meet criteria (odds ratio 1.0, 95% confidence interval [0.6, 1.9], P = .87). Conclusions: Among children who underwent AT, the only significant predictor of obtaining pre-AT PSG was age 1 to 3 years. The rate of adherence to the AAO-HNS guideline recommendations was low (20%), which represents an educational opportunity.

Original languageEnglish (US)
Pages (from-to)1361-1367
Number of pages7
JournalJournal of Clinical Sleep Medicine
Volume14
Issue number8
DOIs
StatePublished - Aug 15 2018

Fingerprint

Polysomnography
Sleep Apnea Syndromes
Otolaryngology
Neck
Head
Guidelines
Otolaryngologists
Odds Ratio
Confidence Intervals
Electronic Health Records
Tertiary Healthcare
Comorbidity
Cohort Studies
Retrospective Studies
Logistic Models
Regression Analysis
Demography

Keywords

  • Adenotonsillectomy
  • Obstructive sleep apnea
  • Pediatric
  • Polysomnography
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Cite this

Predictors of obtaining polysomnography among otolaryngologists prior to adenotonsillectomy for childhood sleep-disordered breathing. / Lam, Derek J.; Shea, Steven A.; Weaver, Edward M.; Mitchell, Ron B.

In: Journal of Clinical Sleep Medicine, Vol. 14, No. 8, 15.08.2018, p. 1361-1367.

Research output: Contribution to journalArticle

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abstract = "Study Objectives: (1) To assess the predictors for obtaining polysomnography (PSG) in children undergoing adenotonsillectomy (AT) for sleep-disordered breathing, and (2) to estimate the adherence to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guideline recommendations for pre-AT PSG. Methods: This was a retrospective cohort study of children who were seen in the Pediatric Otolaryngology Clinic and underwent AT for sleep-disordered breathing over a 13-month period at a single tertiary care children’s hospital. Patients with and without pre-AT PSG were compared using bivariate and logistic regression analysis to identify predictors for PSG. Electronic medical records were reviewed for demographic variables, medical comorbidities, and PSG data. Adherence to AAO-HNS guideline recommendations was estimated by calculating the proportion of patients who had a PSG among those who met the recommended criteria for pre-AT PSG. Results: Mean age was 6.6 ± 3.6 years with 53{\%} male. A total of 65 of 324 children (20{\%}) underwent PSG prior to AT. The only factor significantly associated with pre-AT PSG was age 1 to 3 years (odds ratio 4.5, 95{\%} confidence interval [2.2, 9.0], P < .001). Among patients who met AAO-HNS criteria for pre-AT PSG, 28 of 128 (20{\%}) underwent PSG compared to 35 of 186 (19{\%}) who did not meet criteria (odds ratio 1.0, 95{\%} confidence interval [0.6, 1.9], P = .87). Conclusions: Among children who underwent AT, the only significant predictor of obtaining pre-AT PSG was age 1 to 3 years. The rate of adherence to the AAO-HNS guideline recommendations was low (20{\%}), which represents an educational opportunity.",
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