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Outcomes Assessment of Multi-Level Sleep Surgery in Syndromic Versus Non-Syndromic Children

Suqrat Munawar1, Alexander P Marston1, Terral Patel1

  • 1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.

The Annals of Otology, Rhinology, and Laryngology
|January 11, 2020
PubMed

Insights

Syndromic children undergoing sleep surgery have longer hospital stays, higher costs, and more complex outcomes than non-syndromic children. This difference is more pronounced with multi-level surgeries, highlighting the need for careful risk assessment.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Health Services Research

Background:

  • Sleep disordered breathing and obstructive sleep apnea are common in children.
  • Multi-level sleep surgery is an option for pediatric patients.
  • Understanding outcomes in syndromic versus non-syndromic children is crucial.

Purpose of the Study:

  • To compare length of stay, cost, disposition, and demographics between syndromic and non-syndromic children undergoing multi-level sleep surgery.
  • To identify specific surgical factors influencing outcomes in these groups.
  • To inform clinical decision-making for pediatric sleep surgery.

Main Methods:

  • Retrospective analysis of the Kids' Inpatient Database (1997-2012).
  • Classification of children into syndromic and non-syndromic groups.
  • Stratification by surgical level: tonsillectomy & adenoidectomy (T&A), T&A plus other site, other site surgery.
  • Statistical analysis using Kruskal-Wallis, logistic regression, and chi-square tests.

Main Results:

  • Syndromic children were more likely to undergo multi-level surgery, had longer lengths of stay, higher costs, and non-routine dispositions (P < .001).
  • Syndromic children undergoing T&A plus other site surgery had significantly longer stays than those with T&A alone (6.00 vs 3.63 days, P < .001).
  • Non-syndromic children showed no significant difference in length of stay between these surgical groups (2.01 vs 2.87 days, P > .05).

Conclusions:

  • Syndromic children face higher risks and resource utilization following sleep surgery compared to non-syndromic peers.
  • The benefits and risks of sleep surgery, particularly multi-level procedures, require careful consideration in syndromic populations.
  • Outcomes differ significantly based on syndromic status and surgical complexity, impacting length of stay and disposition.
Abstract

Keywords:
adenoidectomymulti-level sleep surgeryobstructive sleep apneasleep disordered breathingsyndromictonsillectomy

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