Obesity and risk of peri-operative complications in children presenting for adenotonsillectomy

Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA.
International Journal of Pediatric Otorhinolaryngology (Impact Factor: 1.19). 11/2008; 73(1):89-95. DOI: 10.1016/j.ijporl.2008.09.027
Source: PubMed


Adenotonsillectomy (T&A) is a very common surgical procedure in children. With the rising prevalence of childhood overweight and obesity, our goal was to describe the prevalence of overweight/obesity in children presenting for T&A in our institution. We also sought to compare the frequency of peri-operative complications and the likelihood of being admitted following T&A between overweight/obese and normal weight children.
We examined our peri-operative database and extracted clinical, demographic and anthropometric information on 2170 children who underwent T&A between January 2005 and February 2008. Children were classified into normal weight, overweight and obese using published body mass index (BMI) criteria. The incidences of peri-operative complications were compared between the BMI categories. We also examined factors contributing to the likelihood of admission following T&A.
The overall prevalence of overweight and obese was 20.7%. Overweight/obese children were more likely to have intra-operative desaturation (p=0.004), multiple attempts at laryngoscopy (p<0.001), difficult mask ventilation (p=0.001), and post-induction and post-anesthesia care unit (PACU) upper airway obstruction (p<0.001). Additionally, overweight and obese children were more likely to be admitted following T&A. BMI showed a moderate positive correlation with post-operative length of stay (LOS). Multiple logistic regression analysis showed that BMI and presence of medical co-morbidities were independent predictors of LOS.
Overweight and obese children presenting for T&A have a higher incidence of peri-operative complications and are more likely to be admitted and stay for longer than their healthy weight peers.

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Available from: Glenn E. Green, Feb 26, 2014
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