{"doi":"10.1002/ohn.238","title":"Preoperative Predictors of Severe Respiratory Events After Tonsillectomy: Consideration for Pediatric Intensive Care Admission","abstract":"Abstract Objective Few data are available to guide postadenotonsillectomy (AT) pediatric intensive care (PICU) admission. The aim of this study of children with a preoperative polysomnogram (PSG) was to assess whether preoperative information may predict severe respiratory events (SRE) after AT. Study Design Retrospective cohort study. Setting Single tertiary center. Methods Children aged 6 months to 17 years who underwent AT with preoperative polysomnography (2012‐2018) were identified by billing codes. Data were extracted from medical records. SRE were defined as any 1 or more of desaturations <80% requiring intervention; newly initiated positive airway pressure; postoperative intubation; pneumonia/pneumonitis; respiratory code, cardiac arrest, or death. We hypothesized that SRE would be associated with age <24 months, major medical comorbidity, obesity (>95th percentile), apnea‐hypopnea index (AHI) ≥ 30, and O 2 nadir <70% on PSG. Analysis was performed with multivariable logistic regression. Results Of 1774 subjects, 28 (1.7%) experienced SRE. Compared to those without, children with SRE were on average younger (3 vs 5 years, p < .01) with a greater probability of medical comorbidities (59% vs 18%, p < .001). After adjustment for sex, black race, obesity, and age <24 months, children with major medical comorbidity were more likely than other children to have SRE (odds ratio [OR]: 14.2; 95% confidence interval [CI]: [5.7, 35.2]), as were children with AHI ≥ 30 (OR: 7.7 [3.0, 19.9]), or O 2 nadir <70% (OR 6.1 [2.1, 17.9]). Age, obesity, sex, and black race did not independently predict SRE. Conclusion PICU admission may be most prudent for children with complex medical co‐morbidities, high AHI (>30), and/or low O 2 nadir (<70%).","journal":"Otolaryngology","year":2023,"id":374238,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8539,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1136221,"name":"Michael P. Puglia","orcid":null,"position":1,"is_corresponding":false},{"id":1109039,"name":"Bishr Haydar","orcid":"0000-0003-2709-189X","position":2,"is_corresponding":false},{"id":544276,"name":"Elizabeth S. Jewell","orcid":"0000-0002-4395-6331","position":3,"is_corresponding":false},{"id":724456,"name":"Aleda M. Leis","orcid":"0000-0003-2867-9062","position":4,"is_corresponding":false},{"id":1135802,"name":"Nithin S. Peddireddy","orcid":"0000-0001-5902-0047","position":5,"is_corresponding":false},{"id":367792,"name":"Ronald D. Chervin","orcid":null,"position":6,"is_corresponding":false},{"id":724455,"name":"Erin M. Kirkham","orcid":"0000-0001-8975-3022","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T01:16:11.341687Z","pmid":"36939624","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}