The indications for postoperative admission after tonsillectomy in children >3 years of age are less well defined than for children <3 years old, and typically include severe obstructive sleep apnea (OSA), obesity, comorbidities, or behavioral factors. Inpatient care after tonsillectomy typically consists of respiratory monitoring and support, as respiratory compromise is the most common complication after pediatric tonsillectomy. We aim to evaluate risk factors associated with postoperative oxygen supplementation and to identify high risk populations within the admitted population who use additional resources or require additional interventions. Retrospective chart review of patients between the ages of 3 and 18 years old who underwent tonsillectomy by four surgeons at a tertiary care children's hospital was performed. Data including demographics, comorbidities, surgical intervention, pre- and postoperative AHI, admission, postoperative oxygen requirement, and postoperative complications was collected and analyzed. There were 401 patients included in the analysis. Of the patients in this study, 65.59% were male, 43.39% were Latino, and 53.87% were ages 3 to 7. Of the 397 patients with a record for supplemental oxygen, 36 (9.07%) received supplemental oxygen. The LASSO regression odds ratios (OR) found to be important for modeling supplemental oxygen use (in decreasing order of magnitude) are BMI ≥35 (OR = 2.30), pre-op AHI >30 (OR = 2.28), gastrointestinal comorbidities (OR = 2.20), musculoskeletal comorbidities (OR = 1.91), cardiac comorbidities (OR = 1.20), pulmonary comorbidities (OR = 1.14), and BMI 30 to <35 (OR = 1.07). Female gender was found to be negatively associated with risk of supplemental oxygen use (OR = 0.84). Age, race, AHI ≥15–30, neurologic comorbidities, syndromic patients, admission reason, and undergoing other procedures concomitantly were not found to be associated with increased postoperative oxygen requirement. BMI ≥30, pre-op AHI >30, male gender, and gastrointestinal, musculoskeletal, cardiac, and pulmonary comorbidities are all associated with postoperative supplemental oxygen use. Age, race, AHI ≥15–30, neurologic comorbidities, syndromic patients, admission reason, and undergoing other procedures concomitantly were not found to be associated with increased postoperative oxygen requirement.

中文翻译：

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3岁以上儿童扁桃体切除术后的补充氧气需求

与 3 岁以下儿童相比，3 岁以上儿童扁桃体切除术后入院的指征不太明确，通常包括严重阻塞性睡眠呼吸暂停 (OSA)、肥胖、合并症或行为因素。扁桃体切除术后的住院护理通常包括呼吸监测和支持，因为呼吸损害是小儿扁桃体切除术后最常见的并发症。我们的目的是评估与术后补氧相关的危险因素，并确定入院人群中使用额外资源或需要额外干预措施的高危人群。对三级儿童医院四名外科医生接受扁桃体切除术的 3 岁至 18 岁患者进行了回顾性图表审查。收集和分析的数据包括人口统计、合并症、手术干预、术前和术后 AHI、入院、术后需氧量和术后并发症。分析中纳入了 401 名患者。本研究的患者中，65.59%为男性，43.39%为拉丁裔，53.87%为3至7岁。在397名有吸氧记录的患者中，36名（9.07%）接受了吸氧。发现对补充氧气使用建模很重要的 LASSO 回归比值比 (OR)（按数量级递减）为 BMI ≥35 (OR = 2.30)、术前 AHI >30 (OR = 2.28)、胃肠道合并症 (OR = 2.28) = 2.20）、肌肉骨骼合并症（OR = 1.91）、心脏合并症（OR = 1.20）、肺部合并症（OR = 1.14）和 BMI 30 至 <35（OR = 1.07）。研究发现，女性性别与吸氧风险呈负相关（OR = 0.84）。年龄、种族、AHI ≥15-30、神经系统合并症、综合征患者、入院原因以及同时接受其他手术均未发现与术后需氧量增加相关。 BMI≥30、术前AHI>30、男性以及胃肠道、肌肉骨骼、心脏和肺部合并症都与术后补充氧气的使用有关。年龄、种族、AHI ≥15-30、神经系统合并症、综合征患者、入院原因以及同时接受其他手术均未发现与术后需氧量增加相关。