ArticleThe Laryngoscope2026
Utility of Preoperative Cardiac Workup for Children With Very Severe Obstructive Sleep Apnea.
Article in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveWe aimed to examine the prevalence and utility of obtaining a preoperative cardiac workup in children with very severe OSA prior to adenotonsillectomy (AT).
methodsWe conducted a review of children 2-18 years with very severe OSA (Apnea-Hypopnea Index [AHI] ≥ 25) who underwent AT between 2018 and 2024. Wilcoxon rank-sum and Spearman's rho (ρ) tests were performed to determine associations between demographics, cardiac workup, polysomnography parameters, and length of stay [LOS].
resultsOf 144 patients with very severe OSA, 38 patients (26.4%) underwent a preoperative cardiac workup. Three of 38 (7.9%) had abnormal findings; all three were obese, aged 13-16 years, and had preoperative AHI > 50. None underwent additional testing or were started on CPAP preoperatively. There was no association between a cardiac workup, obesity, sex, or age and improvement in AHI. Higher preoperative AHI and younger age correlated to longer LOS (p = 0.040, ρ = 0.17 and p = 0.0007, ρ = -0.28, respectively).
conclusionIn children with very severe OSA, obtaining a preoperative cardiac workup had a low yield of positive findings and was not associated with perioperative course. Adolescent patients with obesity and preoperative AHI > 50 events/h may be at highest risk for abnormal cardiac findings. Our study suggests that a more selective approach to preoperative cardiopulmonary workup may decrease healthcare expenses and minimize delays in care without deleterious effects on patient outcomes and management. LEVEL OF EVIDENCE: 3:
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