{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:01:51Z","timestamp":1780030911316,"version":"3.53.1"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"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":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the effectiveness of a pre\u2010operative triaging model for paediatric adenotonsillectomy in identifying risk of early post\u2010operative respiratory complications, in order to propose an evidence\u2010based triaging model for day\u2010case paediatric adenotonsillectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A retrospective cohort study of 2953 children between 2\u2010 and 12\u2010years\u2010old undergoing adenotonsillectomy for obstructive sleep apnoea (OSA) between January 2011 and December 2019. Patients were triaged as either low\u2010risk or high\u2010risk for post\u2010operative respiratory complications based on age, comorbidities and results of pre\u2010operative investigation with either overnight oximetry or polysomnography. Pre\u2010operative factors including respiratory investigations, intra\u2010operative factors and post\u2010operative course were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 2953 patients enrolled in this study, 1229 patients were deemed low\u2010risk, and 1724 patients were deemed high\u2010risk. Total respiratory complication rate in low\u2010risk patients was 1.5% requiring either repositioning or prolonged oxygenation, with no major respiratory complications requiring admission to the intensive care unit (ICU) or non\u2010invasive ventilation. Total respiratory complication rate in the high\u2010risk cohort was 11.7%. In this cohort, five patients required non\u2010invasive ventilation and seven had an unplanned admission to ICU for monitoring. Severity of OSA and the presence of recovery room complications were the most significant independent risk factors associated with post\u2010operative respiratory compromise, with severe OSA conferring an odds ratio of 9.5 (95% CI 5.0\u201318.0) of respiratory compromise and 13.6 (95% CI 3.4\u201354.9) in the presence of any complications in the recovery room.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre\u2010operative oximetry and\/or polysomnography are useful tools to aid triaging patients and stratifying risk when determining safety for day\u2010case paediatric adenotonsillectomy.<\/jats:p>\n                  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