{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:06:33Z","timestamp":1789185993364,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to examine the prevalence and utility of obtaining a preoperative cardiac workup in children with very severe OSA prior to adenotonsillectomy (AT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a review of children 2\u201318\u2009years with very severe OSA (Apnea\u2010Hypopnea Index [AHI] \u2265\u200925) who underwent AT between 2018 and 2024. Wilcoxon rank\u2010sum and Spearman's rho (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      ) tests were performed to determine associations between demographics, cardiac workup, polysomnography parameters, and length of stay [LOS].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 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\u201316\u2009years, and had preoperative AHI &gt;\u200950. 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 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040,\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.17 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0007,\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u2009\u22120.28, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In 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\u2009&gt;\u200950 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70689","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:51:03Z","timestamp":1781592663000},"page":"4534-4541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of Preoperative Cardiac Workup for Children With Very Severe Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5343-9194","authenticated-orcid":false,"given":"Danny A.","family":"Elias","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-9198","authenticated-orcid":false,"given":"Amber D.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2504-563X","authenticated-orcid":false,"given":"Rachel","family":"Whelan","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"},{"name":"Department of Otolaryngology University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania 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