Predictors of sleep-disordered breathing in children with a history of tonsillectomy and/or adenoidectomy.
OBJECTIVE
To identify predictors of sleep-disordered breathing (SDB) in children who have undergone self-reported tonsillectomy and/or adenoidectomy (TA).


METHODS
Observational study of pediatric participants in a longitudinal genetic-epidemiological cohort study of SDB.


METHODS
Community-based; studies conducted at participants' homes


METHODS
577 children age <18 (10.8+/-4.2 SD) years; 53% female; 48% Black; 76% with a family member identified with SDB.


METHODS
NA.


RESULTS
Medical history assessed by questionnaire. Physical measures made directly. SDB was assessed with overnight inhome cardio-respiratory monitoring. 10% of children (n=60) had had aTA 5.5+/-4.6 yrs previously. An Apnea-Hypopnea Index (AHI, events/hr) > or =5 was found in a higher proportion of children with a reported TA than in children with no history of out surgery (35% vs. 13.7%, p<.001). A TA was reported more frequently for non-Blacks than for Blacks (13.6% non-Blacks, 6.9% Blacks, p=.02). Among children who had a TA, significant predictors of SDB (AHI> or =5) were: Black ethnicity (SDB in 57% vs. 24% of Blacks vs. non-Blacks; adjusted odds ratio (OR): 3.85; 95% CI: 1.11, 13.33) and obesity (OR 3.98; 95% Cl: 1.05, 15.08). SDB also tended to be greater in children with a family member with SDB (OR 2.87; 95% CI: 0.65, 12.07).


CONCLUSIONS
Black children were less likely to have undergone TA but more likely to have SDB after TA surgery. These findings underscore the need to follow children post-TA and for evidence-based studies that define the role of TA in the management of pediatric adenotonsillar disease.
Morton
S
S
Department of Pediatrics, Case Western Reserve University, Rainbow Babies & Children s Hospital, Cleveland, OH 44106, USA.
Rosen
C
C
Larkin
E
E
Tishler
P
P
Aylor
J
J
Redline
S
S
D000233:Adenoidectomy / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy / Q000706:statistics & numerical data*