[Analysis of risk factors for delayed discharge of children undergoing day surgery for mild to moderate obstructive sleep apnea].

Objective

To investigate the risk factors for delayed discharge inchildren with mild to moderate obstructive sleep apnea（OSA） undergoing day surgery.

Methods

The electronic medical records of 374 children with OSA who underwent day surgery at Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to December 2022 were retrospectively analyzed. The patients were divided into a delayed discharge group（38 cases） and a normal discharge group（336 cases） based on their discharge time. The general information, surgical methods, blood routine, surgical duration, tonsil grading, sleep structure, and respiratory parameters of the two groups were compared. Logistic regression analysis was used to identify the risk factors for delayed discharge. A predictive model was established based on the independent risk factors.

Results

The incidence of delayed discharge in children with OSA undergoing day surgery was 10.2%. The logistic regression model showed that surgical method（OR=3.121, 95%CI 1.258-7.738, P=0.014）, being an only child（OR=2.822, 95%CI 1.337-5.958, P=0.006）, and preoperative neutrophil count（OR=0.704, 95%CI 0.534-0.928, P=0.013） were independent risk factors for delayed discharge. The area under the receiver operating characteristic（ROC） curve was measured at 0.812（95%CI 0.742-0.882）, with a sensitivity of 0.744 and a specificity of 0.789, The optimal cutoff value of the model was 0.894. At this cutoff value, the model had a sensitivity of 0.744 and a specificity of 0.789, confirming its predictive accuracy.

Conclusion

Children undergoing adenoidectomy combined with tonsillectomy, those who are only children, or those with a higher preoperative neutrophil count are at an increased risk of delayed discharge.