Retrospective cohort study identifies low-risk children for same-day discharge after tonsillectomy, suggesting safer protocols.
Key Points
The aim is to identify low-risk children with severe obstructive sleep apnea and obesity who can safely be discharged on the same day after tonsillectomy.
Retrospective cohort study of children aged 2-18 years with obesity and severe obstructive sleep apnea undergoing tonsillectomy.
Used Bayesian logistic regression to identify predictors of severe perioperative events.
Evaluated model-based risk stratification and clinical rules based on sensitivity, specificity, and negative predictive value.
Among 304 children, 36 (11.8%) experienced a severe event.
SpO2 nadir was the strongest predictor of severity, with a directional probability of 99.6%.
Clinical rule combining AHI < 25 events/h and SpO2 nadir > 85% showed 85.7% sensitivity and 99.5% negative predictive value.