(1014) Disparities of Obstructive Sleep Apnea in Latino/Hispanic Children: A Review of the Literature

Introduction: Obstructive sleep apnea (OSA) can result in detrimental long-term outcomes for children undergoing vital mental and physical development. Low socioeconomic status, lack of insurance, and non-White race have been identified as disparities in various otolaryngology conditions. We aim to identify disparities related to management and outcomes of OSA treated with tonsillectomy and/or adenoidectomy (T&A). A secondary objective is to identify disease management in Latino/Hispanic children compared to other racial/ethnic groups.

Methods: A comprehensive search of PubMed, Ovid MEDLINE, and Web of Science yielded 504 articles. Inclusion criteria (age ≤18, Latino/Hispanic descent, and treatment involving T&A) included 13 articles eligible for analysis. Data analysis includes descriptive statistics and student t-tests.

Results: Of 196,044 children in this study, 14,2043 (7.3%) were of Hispanic/Latino (H/L) descent, mean age of 6.34 years, and 62,067 (53%) males. Disparities in management were identified in 75% (3/4) articles and include differences in time to care, access to care, and treatment offered between racial groups. Post-T&A outcomes using the apnea-hypopnea index (AHI) reported significant improvement in very severe OSA (mean AHI = 35.07) to persistent severe OSA (mean AHI = 12.8) (p = 0.01). Although improved, severe OSA persisted post-intervention in a group where 75% of articles included more than 40% of H/L children and all articles had over 70% combination of Black and H/L children without full resolution of OSA. Racial breakdown subgroup analysis was provided in 16% of articles, revealing no statistically significant differences in outcomes between White and Latino/Hispanic patients (p > 0.05).

Conclusions: Our search found evident disparities in management of care delivery to Latino/Hispanic children. Further research considering race/ethnicity, sociodemographic, and environmental factors is essential to investigate and can help us understand factors contributing to OSA in this population and a critical step towards providing equitable care.