Risk Factors for Perioperative Respiratory Adverse Events in Children with Recent Upper Respiratory Tract Infection:...

Area of Science:

• Pediatric Anesthesiology
• Respiratory Medicine
• Surgical Risk Assessment

Background:

• Upper respiratory tract infections (URIs) are a common cause of surgical delay in children.
• Optimal timing for surgery after a URI in pediatric patients remains undefined.
• Perioperative respiratory adverse events (RAEs) are a significant concern in pediatric surgery.

Purpose of the Study:

• To evaluate the impact of a URI symptom-free period on RAEs in pediatric surgical patients.
• To identify risk factors associated with perioperative RAEs following URI.
• To establish guidelines for deferring surgery after URI in children.

Main Methods:

• Retrospective review of medical records for 267 pediatric patients (0-13 years) with recent URI.
• Analysis of risk factors, including URI symptom-free duration, for intra- and postoperative RAEs.
• Univariate and multivariate logistic regression analyses were employed.

Main Results:

• RAEs occurred in 8.6% of patients.
• Abnormal preoperative chest images (OR, 7.60) and emergency operations (OR, 2.84) were associated with RAEs.
• A URI symptom-free period of 7-13 days was independently associated with a reduced incidence of RAEs (OR, 0.13).

Conclusions:

• Pediatric patients with recent URI should undergo surgery after a symptom-free interval of at least 1-2 weeks.
• Preoperative chest imaging to rule out abnormalities is crucial for reducing RAEs.
• These findings aid in optimizing surgical timing and reducing perioperative risks in children with URI history.