Impact of AAO-HNS Guideline on Obtaining Polysomnography Prior to Tonsillectomy for Pediatric Sleep-Disordered Breathing.
Impact of AAO-HNS Guideline on Obtaining Polysomnography Prior to Tonsillectomy for Pediatric Sleep-Disordered Breathing.
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AAO-HNS指南对在扁桃体切除术之前获得小儿睡眠呼吸呼吸的影响。
DOI：
10.1177/0194599820926456
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Lam DJ
中科院分区：
文献类型：
--
作者：
Banik GL;Empey RM;Lam DJ
评估2011年美国耳鼻咽喉头颈外科学会(AAO-HNS)指南对儿童睡眠障碍呼吸(SDB)行腺体扁桃体切除术(AT)前多导睡眠图(PSG)的影响。回顾性队列研究。三级儿童医院。研究人群包括在两个12个月的时间段内到我们的儿科耳鼻喉科诊所接受耳鼻喉科AT治疗的所有患者：在2011年AAO-HNS指南发布之前(2010-2011年)和之后(2015-2016)。采用双变量和多变量Logistic回归分析，评估人口统计、保险、共病和儿科睡眠问卷(PSQ)变量与AT前PSG的相关性。与2010年至2011年相比，2015年至2016年接受AT前综合治疗的患者比例更高(30%对22%，p=0.001)。在多变量分析中，神经肌肉疾病的存在是与2010-2011年房颤前PSG相关的唯一预测因素(OR 3.00，95%CI[1.10，8.06]，p=0.03)。神经肌肉疾病(OR2.54，95%CI[1.5 1，4.29]，p<；0.0001)、颅面畸形(OR2.32，95%CI[1.2 0，4.5]，p=0.013)或唐氏综合征(OR3.45，95%CI[1.5 4，7.72]，p=0.003)的存在与AT前PSG有关。PSQ筛查阳性与两个时间段的房颤前PSG发生率降低显著相关。在2011年AAO-HNS指南发布后，在患有SDB和高危合并症的儿童中，AT前PSG的使用率有显著但温和的增长，与AAO-HNS指南的建议一致。然而，总体指南遵从性仍然较低，可能反映了PSG测试能力的限制。
To assess the impact of the 2011 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guideline on practice patterns in obtaining pre-adenotonsillectomy (AT) polysomnography (PSG) for pediatric sleep-disordered breathing (SDB). Retrospective cohort study. Tertiary children’s hospital. The study population included all patients referred to our pediatric otolaryngology clinic for consideration of AT for SDB during two 12-month time periods: before (2010–2011) and after (2015–2016) publication of the 2011 AAO-HNS guideline. Demographic, insurance, comorbidity, and Pediatric Sleep Questionnaire (PSQ) variables were assessed for association with pre-AT PSG using bivariate and multivariate logistic regression analysis. A greater percentage of patients underwent pre-AT PSG in 2015–2016 vs. 2010–2011 (30% vs. 22%, p=0.001). On multivariate analysis, presence of neuromuscular disorder was the only predictor associated with pre-AT PSG in 2010–2011 (OR 3.00, 95% CI [1.10, 8.06], p=0.03). Presence of neuromuscular disorder (OR 2.54, 95% CI [1.51, 4.29], p<0.0001), craniofacial anomaly (OR 2.32, 95% CI [1.20, 4.50], p=0.013), or Down syndrome (OR 3.45, 95% CI [1.54, 7.72], p=0.003) was associated with pre-AT PSG in 2015–2016. Positive PSQ screen was significantly associated with decreased odds of pre-AT PSG in both time periods. After publication of the 2011 AAO-HNS guideline, there was a significant but modest increase in pre-AT PSG utilization in children with SDB and high-risk comorbidities at our institution, consistent with AAO-HNS guideline recommendations. However, overall guideline adherence remains low and may reflect limitations in PSG testing capacity.
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影响因子：
3.4
作者：
Erickson, Britt K.;Larson, Dirk R.;Orvidas, Laura J.
通讯作者：
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DOI：
10.1016/j.ijporl.2013.06.009
发表时间：
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作者：
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影响因子：
8
作者：
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通讯作者：
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DOI：
10.1016/j.ijporl.2019.02.008
发表时间：
2019-05-01
影响因子：
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作者：
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通讯作者：
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