title: Clinical indicators that predict the presence of moderate to severe obstructive sleep apnea after adenotonsillectomy in children.
abstract: OBJECTIVE
  To determine if clinical indicators can predict the presence of moderate to severe Obstructive Sleep Apnea (OSA) after Adenotonsillectomy (T&A) in children.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Urban Tertiary Care Pediatric Hospital.
  
  
  METHODS
  Parents of children (<18 yrs.) with OSA completed a 55-item questionnaire based on their child's symptoms at the time of preoperative polysomnography and then again at the follow up polysomnography completed 3 to 6 months after T&A.
  
  
  METHODS
  55 item questionnaire, polysomnography variables.
  
  
  RESULTS
  97 children were included (59 Male and 38 Female). The mean preoperative apnea hypopnea index (AHI) was 30.5±31.6/h and the mean postoperative AHI was 4.4±6.0/h. After T&A, all 97 children had reduction in AHI, and 35 (36.1%) no longer had OSA (AHI<1/h). The total symptom scores decreased from 15.8±9.4 to 11.3±8.7 after T&A (p<.0001). Fourteen symptoms highly predictive of moderate to severe OSA were identified in the univariate analysis (p<0.1). Using a cut-point of 4, this 14-item subscale illustrated an overall predictability of 72.2% (73.7% sensitivity and 70.0% specificity) for identifying children with moderate to severe OSA.
  
  
  CONCLUSIONS
  A cluster of 14 clinical sleep symptoms are highly predictive of moderate to severe OSA and can serve as clinical predictor for the presence of moderate to severe OSA after T&A.
authors.affiliation: Department of Surgery, Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Otolaryngology Head & Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Bharat
authors.initials: B
authors.lastname: Bhushan
authors.affiliation: Sleep Medicine Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pulmonary Medicine, Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sheldon
authors.affiliation: Department of Biostatistics, Northwestern University, Chicago, IL.
authors.forename: Edward
authors.initials: E
authors.lastname: Wang
authors.affiliation: Department of Surgery, Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Otolaryngology Head & Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: jschroeder@luriechildrens.org.
authors.forename: James W
authors.initials: JW
authors.lastname: Schroeder
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000379:methods*; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires; D014068:Tonsillectomy / Q000009:adverse effects*