TY - JOUR
T1 - Assessment of neighborhood-level disadvantage and pediatric obstructive sleep apnea severity
AU - Kim, Jenny
AU - Kou, Yann Fuu
AU - Chorney, Stephen R.
AU - Mitchell, Ron B.
AU - Johnson, Romaine F.
N1 - Publisher Copyright:
© 2023 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.
PY - 2023/8
Y1 - 2023/8
N2 - Objectives: To examine the relationship between neighborhood-level advantage and severe obstructive sleep apnea (OSA) in children. Methods: A retrospective case–control study was conducted on 249 children who underwent adenotonsillectomy and had full-night polysomnography conducted within 6 months prior. Patients were divided into more or less socioeconomically disadvantaged groups using a validated measure, the area deprivation index (ADI). The primary outcomes were the relationship between the apnea–hypopnea index (AHI) and the presence of severe OSA, and the secondary outcome was residual moderate or greater OSA after tonsillectomy. Results: Of the 249 children included in the study, 175 (70.3%) were socially disadvantaged (ADI > 50). The median (interquartile range [IQR]) age was 9.4 (7.3–12.3) years, 129 (51.8%) were male, and the majority were White (151, 60.9%), Black (51, 20.6%), and/or of Hispanic (155, 62.5%) ethnicity. A total of 140 (56.2%) children were obese. The median (IQR) AHI was 8.9 (3.9–20.2). There was no significant difference in the median AHI or the presence of severe OSA between the more and less disadvantaged groups. Severe OSA was found to be associated with obesity (odds ratio [OR] = 3.13, 95% confidence interval [CI] = 1.83–5.34), and residual moderate or greater OSA was associated with older age (OR = 1.20, 95% CI = 1.05–1.38). Conclusions: The ADI was not significantly associated with severe OSA or residual OSA in this cohort of children. Although more neighborhood-level disadvantage may increase the risk of comorbidities associated with OSA, it was not an independent risk factor in this study. Level of Evidence: Level 4.
AB - Objectives: To examine the relationship between neighborhood-level advantage and severe obstructive sleep apnea (OSA) in children. Methods: A retrospective case–control study was conducted on 249 children who underwent adenotonsillectomy and had full-night polysomnography conducted within 6 months prior. Patients were divided into more or less socioeconomically disadvantaged groups using a validated measure, the area deprivation index (ADI). The primary outcomes were the relationship between the apnea–hypopnea index (AHI) and the presence of severe OSA, and the secondary outcome was residual moderate or greater OSA after tonsillectomy. Results: Of the 249 children included in the study, 175 (70.3%) were socially disadvantaged (ADI > 50). The median (interquartile range [IQR]) age was 9.4 (7.3–12.3) years, 129 (51.8%) were male, and the majority were White (151, 60.9%), Black (51, 20.6%), and/or of Hispanic (155, 62.5%) ethnicity. A total of 140 (56.2%) children were obese. The median (IQR) AHI was 8.9 (3.9–20.2). There was no significant difference in the median AHI or the presence of severe OSA between the more and less disadvantaged groups. Severe OSA was found to be associated with obesity (odds ratio [OR] = 3.13, 95% confidence interval [CI] = 1.83–5.34), and residual moderate or greater OSA was associated with older age (OR = 1.20, 95% CI = 1.05–1.38). Conclusions: The ADI was not significantly associated with severe OSA or residual OSA in this cohort of children. Although more neighborhood-level disadvantage may increase the risk of comorbidities associated with OSA, it was not an independent risk factor in this study. Level of Evidence: Level 4.
KW - area deprivation index
KW - neighborhood-level disadvantage
KW - pediatric obstructive sleep apnea
KW - socioeconomic status
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U2 - 10.1002/lio2.1098
DO - 10.1002/lio2.1098
M3 - Article
C2 - 37621268
AN - SCOPUS:85162951981
SN - 2378-8039
VL - 8
SP - 1114
EP - 1123
JO - Laryngoscope investigative otolaryngology
JF - Laryngoscope investigative otolaryngology
IS - 4
ER -