0781 Perioperative Delta Weight and Pediatric Obstructive Sleep Apnea Resolution After Adenotonsillectomy

Introduction Obstructive sleep apnea (OSA) affects 1-5% of pediatric patients and has detrimental effects on childhood growth and development. Adenotonsillectomy (AT) is the most effective treatment for pediatric OSA but is correlated with postoperative weight gain in children. We hypothesized that higher perioperative weight gain correlates with lower rates of OSA resolution in pediatric patients. Methods We conducted a retrospective cohort study at a tertiary academic medical center analyzing demographic, weight, and polysomnography (PSG) data for 250 patients from 2-17 years of age between January 2021 and December 2022. We performed univariate and multivariate logistical regression analyses. Results Following AT, 27.7% (n=68/250) of patients had residual OSA (AHI>5). Compared to patients without residual OSA, those with residual OSA were predominately male (77.9% vs 60.2%, p=0.007), had a higher median age (7.5 years vs 6.2 years; p=0.04), a higher median weight (41.8 vs 27.7 kg; p=0.01), and a higher median preoperative BMI (27.7 vs 20.9; p=0.001). Logistic regression showed that for every one-unit (1 kg) increase in perioperative weight, the odds of residual OSA increase by 6.0% (OR=1.06, 95% CI=1.02-1.10). For every one unit increase in baseline AHI correlated to 2% increase in the odds of residual OSA (OR=1.02, 95% CI=1.01-1.03, P=0.001). The odds of having residual OSA increased by 92% for Black or African American patients (OR=1.92, 95% CI=1.04-3.55, P=0.037). Conclusion Perioperative weight gain around the time of AT is correlated to higher rates of residual severe OSA in children. Weight loss and/or control is an important adjunctive treatment to ensure OSA resolution. Support (if any)