1 Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
2 Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
Otolaryngol Head Neck Surg. 2019 Jul;161(1):157-163. doi: 10.1177/0194599819837243. Epub 2019 Mar 26.
To compare the percentage and mean age of children with Down syndrome (DS) who underwent polysomnography (PSG) to evaluate for obstructive sleep apnea (OSA) before and after the introduction of the American Academy of Pediatrics guidelines recommending universal screening by age 4 years.
Retrospective cohort study.
Single tertiary pediatric hospital.
This study is a review of patients with DS seen in a subspecialty clinic. Children born preguidelines (2000-2006) were compared with children born postguidelines (2007-2012) regarding percentage receiving PSG, age at first PSG, and rate of OSA.
We included 766 children with DS; 306 (40%) were born preguidelines. Overall, 61% (n = 467) underwent PSG, with a mean ± SD age of 4.2 ± 2.9 years at first PSG; 341 (44.5%) underwent first PSG by age 4 years. The rate of OSA (obstructive index ≥1 event/hour) among children undergoing first PSG was 78.2%. No difference was seen in the percentage receiving PSG preguidelines (63.4%) versus postguidelines (59.4%, = .26). The mean age at the time of first PSG was 5.3 ± 3.5 years preguidelines versus 3.4 ± 2.0 years postguidelines ( < .0001). Children in the postguidelines cohort were more likely to undergo first PSG during the ages of 1 through 4 years (67.4% vs 52.1%, < .0001). There was no difference in rates of OSA between the pre- and postguidelines cohorts (79.8% vs 75.9%, = .32).
Nearly two-thirds of children with DS (61%) underwent PSG overall, with a significant shift toward completion of PSG at an earlier age after the introduction of the American Academy of Pediatrics guidelines for universal screening for OSA.
比较在引入美国儿科学会推荐的 4 岁年龄进行普遍筛查指南前后，进行多导睡眠图（PSG）以评估阻塞性睡眠呼吸暂停（OSA）的唐氏综合征（DS）患儿的百分比和平均年龄。
回顾性队列研究。
单一体儿科医院。
这项研究是对在专科诊所就诊的 DS 患儿进行的回顾性研究。将出生于指南前（2000-2006 年）的患儿与出生于指南后（2007-2012 年）的患儿进行比较，比较接受 PSG 的百分比、首次 PSG 的年龄以及 OSA 的发生率。
我们纳入了 766 名 DS 患儿，其中 306 名（40%）出生于指南前。总体而言，61%（n=467）接受了 PSG，首次 PSG 的平均年龄为 4.2±2.9 岁；341 名（44.5%）在 4 岁前进行了首次 PSG。首次 PSG 中 OSA 发生率（阻塞指数≥1 次/小时）为 78.2%。在接受 PSG 的百分比方面，指南前（63.4%）与指南后（59.4%，=.26）之间无差异。首次 PSG 的平均年龄在指南前为 5.3±3.5 岁，指南后为 3.4±2.0 岁（<.0001）。在指南后队列中，更多的患儿在 1 至 4 岁期间进行了首次 PSG（67.4%比 52.1%，<.0001）。在 OSA 发生率方面，前、后指南组之间无差异（79.8%比 75.9%，=.32）。
近三分之二的 DS 患儿（61%）总体上接受了 PSG，在美国儿科学会发布普遍筛查 OSA 的指南后，PSG 的完成年龄明显提前。
