Abstract Rationale Pediatric sleep apnea (PSA) is increasingly recognized as a significant contributor to cardiometabolic, neurobehavioral, and peri-operative morbidity. While most cases are diagnosed and managed in outpatient settings, limited data exist on children with PSA-related hospitalizations (PSAH) who may represent a more severe spectrum of condition. We evaluated the temporal trends, demographic characteristics, and independent predictors of PSAH using the 2012-2019 Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Database (KID). Methods This was a retrospective, repeated cross-sectional analysis of the 2012, 2016, and 2019 editions of the KID. KID is the largest publicly available all-payer pediatric inpatient care database in the United States and it provides national estimates of hospital stays for patients younger than 21 years. We identified PSAH with ICD-9-CM and ICD-10-CM codes. The exposure was PSAH and the outcomes were the temporal trends, demographic characteristics, and factors independently associated with PSAH. We used weighted logistic regression, expressed as odds ratios (OR) with 95% confidence intervals (CI), to evaluate trends and assess independent associations between PSAH and key comorbidities. Results Of 18 million pediatric hospitalizations, 124,263 were PSAH (0.66%). Between 2012 and 2019, PSAH increased from 0.47% to 0.87% of all pediatric hospitalizations, an 85% rise in the inpatient PSA burden. PSAH were more likely to be males (58%), of White race (45%), have Medicaid/Medicare (93%) and likely to live in the South census region (3%). About 30% were admitted through the emergency department. Comorbidities that had the strongest association with admission were adenotonsillar hypertrophy (OR 268, CI: 241.1 - 297.9), Down syndrome (OR = 19.9, CI: 16.8 - 19.3) and obesity (OR = 10.2, CI: 9.6 - 10.9). Other comorbidities significantly associated with admission were craniofacial anomalies, epilepsy, cerebral palsy, pulmonary hypertension asthma, hypertension, pulmonary hypertension, and diabetes. Conclusions The rise in PSAH likely reflects both increasing true incidence—driven by pediatric obesity—and improved recognition following the 2012 AAP guidelines. More than 90% of PSAH had public insurance and this suggests socio-economic barriers to prompt screening, diagnoses, and management in the outpatient setting. PSAH were associated with multiple comorbidities, suggesting that screening of high-risk groups and initiation of prompt management can reduce hospitalizations. This abstract is funded by: None
Sunny et al. (Fri,) studied this question.
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