Temporal trends in inpatient pediatric sleep apnea surgery: 1993 through 2010

David F. Smith, Ting Sa, Matthew Fenchel, Aliza P. Cohen, Christine Heubi, Sally R. Shott, Christine Gourin, Stacey L. Ishman

Research output: Contribution to journalArticle

Abstract

Objectives/Hypothesis: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. Study Design: Repeated cross-sectional study. Methods: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling. Results: Inpatient surgical sleep procedures increased from 45,671 performed in 1993 to 2000 (study period 1) to 80,020 in 2001 to 2010 (study period 2). Overall, patients were commonly male (61.3%), privately insured (46.8%), 2 to 6 years old (39.4%), and white (36.4%). Obesity was reported in 4.6% and 6.7% of children during study periods 1 and 2, respectively (P < .0001). Tonsillectomy (with and without adenoidectomy) was the most commonly performed procedure in both study periods. With the exception of uvulopalatopharyngoplasty and tracheostomy, all sleep procedures increased over time; however, multilevel surgery did not significantly increase (P = .28). Children who underwent sleep surgery during study period 2 were more likely to receive a supraglottoplasty (P = .0125) and to undergo procedures at high-volume hospitals (P = .0311), and less likely to undergo a tracheostomy (P < .0001). Conclusions: These data reflect changing trends in the surgical management of pediatric OSA, with significant increases in nasal and hypopharyngeal procedures, particularly lingual tonsillectomy and supraglottoplasty. Unlike the trend in adults, multilevel surgery in children with sleep disordered breathing or OSA has not yet been integrated into routine clinical practice.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - 2016

Fingerprint

Sleep Apnea Syndromes
Inpatients
Pediatrics
Sleep
Obstructive Sleep Apnea
Tonsillectomy
Tracheostomy
Nose
High-Volume Hospitals
Adenoidectomy
Tongue
Obesity
Cross-Sectional Studies

Keywords

  • Comorbidities
  • Nationwide Inpatient Sample
  • Obstructive sleep apnea
  • Pediatric
  • Sleep procedures
  • Sleep surgery
  • Sleep-disordered breathing
  • Surgical trends

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Smith, D. F., Sa, T., Fenchel, M., Cohen, A. P., Heubi, C., Shott, S. R., ... Ishman, S. L. (Accepted/In press). Temporal trends in inpatient pediatric sleep apnea surgery: 1993 through 2010. Laryngoscope. https://doi.org/10.1002/lary.26304

Temporal trends in inpatient pediatric sleep apnea surgery : 1993 through 2010. / Smith, David F.; Sa, Ting; Fenchel, Matthew; Cohen, Aliza P.; Heubi, Christine; Shott, Sally R.; Gourin, Christine; Ishman, Stacey L.

In: Laryngoscope, 2016.

Research output: Contribution to journalArticle

Smith, David F. ; Sa, Ting ; Fenchel, Matthew ; Cohen, Aliza P. ; Heubi, Christine ; Shott, Sally R. ; Gourin, Christine ; Ishman, Stacey L. / Temporal trends in inpatient pediatric sleep apnea surgery : 1993 through 2010. In: Laryngoscope. 2016.
@article{9517240b6d244fe6ba0e5c919cdaa965,
title = "Temporal trends in inpatient pediatric sleep apnea surgery: 1993 through 2010",
abstract = "Objectives/Hypothesis: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. Study Design: Repeated cross-sectional study. Methods: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling. Results: Inpatient surgical sleep procedures increased from 45,671 performed in 1993 to 2000 (study period 1) to 80,020 in 2001 to 2010 (study period 2). Overall, patients were commonly male (61.3{\%}), privately insured (46.8{\%}), 2 to 6 years old (39.4{\%}), and white (36.4{\%}). Obesity was reported in 4.6{\%} and 6.7{\%} of children during study periods 1 and 2, respectively (P < .0001). Tonsillectomy (with and without adenoidectomy) was the most commonly performed procedure in both study periods. With the exception of uvulopalatopharyngoplasty and tracheostomy, all sleep procedures increased over time; however, multilevel surgery did not significantly increase (P = .28). Children who underwent sleep surgery during study period 2 were more likely to receive a supraglottoplasty (P = .0125) and to undergo procedures at high-volume hospitals (P = .0311), and less likely to undergo a tracheostomy (P < .0001). Conclusions: These data reflect changing trends in the surgical management of pediatric OSA, with significant increases in nasal and hypopharyngeal procedures, particularly lingual tonsillectomy and supraglottoplasty. Unlike the trend in adults, multilevel surgery in children with sleep disordered breathing or OSA has not yet been integrated into routine clinical practice.",
keywords = "Comorbidities, Nationwide Inpatient Sample, Obstructive sleep apnea, Pediatric, Sleep procedures, Sleep surgery, Sleep-disordered breathing, Surgical trends",
author = "Smith, {David F.} and Ting Sa and Matthew Fenchel and Cohen, {Aliza P.} and Christine Heubi and Shott, {Sally R.} and Christine Gourin and Ishman, {Stacey L.}",
year = "2016",
doi = "10.1002/lary.26304",
language = "English (US)",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Temporal trends in inpatient pediatric sleep apnea surgery

T2 - 1993 through 2010

AU - Smith, David F.

AU - Sa, Ting

AU - Fenchel, Matthew

AU - Cohen, Aliza P.

AU - Heubi, Christine

AU - Shott, Sally R.

AU - Gourin, Christine

AU - Ishman, Stacey L.

PY - 2016

Y1 - 2016

N2 - Objectives/Hypothesis: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. Study Design: Repeated cross-sectional study. Methods: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling. Results: Inpatient surgical sleep procedures increased from 45,671 performed in 1993 to 2000 (study period 1) to 80,020 in 2001 to 2010 (study period 2). Overall, patients were commonly male (61.3%), privately insured (46.8%), 2 to 6 years old (39.4%), and white (36.4%). Obesity was reported in 4.6% and 6.7% of children during study periods 1 and 2, respectively (P < .0001). Tonsillectomy (with and without adenoidectomy) was the most commonly performed procedure in both study periods. With the exception of uvulopalatopharyngoplasty and tracheostomy, all sleep procedures increased over time; however, multilevel surgery did not significantly increase (P = .28). Children who underwent sleep surgery during study period 2 were more likely to receive a supraglottoplasty (P = .0125) and to undergo procedures at high-volume hospitals (P = .0311), and less likely to undergo a tracheostomy (P < .0001). Conclusions: These data reflect changing trends in the surgical management of pediatric OSA, with significant increases in nasal and hypopharyngeal procedures, particularly lingual tonsillectomy and supraglottoplasty. Unlike the trend in adults, multilevel surgery in children with sleep disordered breathing or OSA has not yet been integrated into routine clinical practice.

AB - Objectives/Hypothesis: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. Study Design: Repeated cross-sectional study. Methods: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling. Results: Inpatient surgical sleep procedures increased from 45,671 performed in 1993 to 2000 (study period 1) to 80,020 in 2001 to 2010 (study period 2). Overall, patients were commonly male (61.3%), privately insured (46.8%), 2 to 6 years old (39.4%), and white (36.4%). Obesity was reported in 4.6% and 6.7% of children during study periods 1 and 2, respectively (P < .0001). Tonsillectomy (with and without adenoidectomy) was the most commonly performed procedure in both study periods. With the exception of uvulopalatopharyngoplasty and tracheostomy, all sleep procedures increased over time; however, multilevel surgery did not significantly increase (P = .28). Children who underwent sleep surgery during study period 2 were more likely to receive a supraglottoplasty (P = .0125) and to undergo procedures at high-volume hospitals (P = .0311), and less likely to undergo a tracheostomy (P < .0001). Conclusions: These data reflect changing trends in the surgical management of pediatric OSA, with significant increases in nasal and hypopharyngeal procedures, particularly lingual tonsillectomy and supraglottoplasty. Unlike the trend in adults, multilevel surgery in children with sleep disordered breathing or OSA has not yet been integrated into routine clinical practice.

KW - Comorbidities

KW - Nationwide Inpatient Sample

KW - Obstructive sleep apnea

KW - Pediatric

KW - Sleep procedures

KW - Sleep surgery

KW - Sleep-disordered breathing

KW - Surgical trends

UR - http://www.scopus.com/inward/record.url?scp=84994259591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994259591&partnerID=8YFLogxK

U2 - 10.1002/lary.26304

DO - 10.1002/lary.26304

M3 - Article

C2 - 27641366

AN - SCOPUS:84994259591

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

ER -