Dahl John P, Miller Craig, Purcell Patricia L, Zopf David A, Johnson Kaalan, Horn David L, Chen Maida L, Chan Dylan K, Parikh Sanjay R
Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA Riley Hospital for Children, Indianapolis, Indiana, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, USA Seattle Children's Hospital, Seattle, Washington, USA.
Otolaryngol Head Neck Surg. 2016 Oct;155(4):676-80. doi: 10.1177/0194599816653113. Epub 2016 Jun 14.
To determine if standardized intraoperative scoring of anatomic obstruction in children with obstructive sleep apnea correlates with the apnea-hypopnea index (AHI) and lowest oxygen saturation on preprocedural polysomnogram (PSG). A secondary objective was to determine if age, presence of a syndrome, or previous adenotonsillectomy affect this correlation.
Case series with chart review.
Two tertiary care children's hospitals.
Patients with a preprocedural PSG who underwent drug-induced sleep endoscopy (DISE) over a 4-year period.
All DISEs were graded in a systematic manner with the Chan-Parikh (C-P) scoring system. AHI and nadir oxygen saturations were extracted from preprocedural PSG. Data were analyzed with a multivariate linear regression model that controlled for age at time of sleep endoscopy, syndrome diagnosis, and previous adenotonsillectomy.
A total of 127 children underwent PSG prior to DISE: 56 were syndromic, and 21 had a previous adenotonsillectomy. Mean AHI was 13.6 ± 19.6 (± SD), and mean oxygen nadir was 85.4% ± 9.4%. Mean C-P score was 5.9 ± 2.7. DISE score positively correlated with preoperative AHI (r = 0.36, P < .0001) and negatively correlated with oxygen nadir (r = -0.26, P = .004). The multivariate linear regression models estimated that for every 1-point increase in C-P score, there is a 2.6-point increase in AHI (95% confidence interval: 1.4-3.8, P < .001) and a 1.1% decrease in the lowest oxygen saturation (95% confidence interval: -1.7 to -0.6, P < .001).
The C-P scoring system for pediatric DISE correlates with both AHI and lowest oxygen saturation on preprocedural PSG.
确定儿童阻塞性睡眠呼吸暂停患者术中解剖性梗阻的标准化评分是否与术前多导睡眠图（PSG）的呼吸暂停低通气指数（AHI）及最低氧饱和度相关。次要目的是确定年龄、综合征的存在或既往腺样体扁桃体切除术是否会影响这种相关性。
病例系列研究并进行图表回顾。
两家三级儿童专科医院。
在4年期间接受药物诱导睡眠内镜检查（DISE）且术前有PSG检查的患者。
所有DISE均采用Chan-Parikh（C-P）评分系统进行系统分级。从术前PSG中提取AHI和最低氧饱和度。采用多变量线性回归模型对数据进行分析，该模型控制了睡眠内镜检查时的年龄、综合征诊断及既往腺样体扁桃体切除术。
共有127名儿童在DISE前接受了PSG检查：56名患有综合征，21名有既往腺样体扁桃体切除术史。平均AHI为13.6±19.6（±标准差），平均最低氧饱和度为85.4%±9.4%。平均C-P评分为5.9±2.7。DISE评分与术前AHI呈正相关（r = 0.36，P <.0001），与最低氧饱和度呈负相关（r = -0.26，P =.004）。多变量线性回归模型估计，C-P评分每增加1分，AHI增加2.6分（95%置信区间：1.4 - 3.8，P <.001），最低氧饱和度降低1.1%（95%置信区间：-1.7至-0.6，P <.001）。
儿童DISE的C-P评分系统与术前PSG的AHI及最低氧饱和度均相关。
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