@article{3121921,
    title = "Assessing the need for adenotonsillectomy for sleep-disordered breathing in a community setting: A secondary outcome measures analysis of a randomized controlled study",
    author = "Papadakis, C.E. and Chaidas, K. and Chimona, T.S. and Zisoglou, M. and Ladias, A. and Proimos, E.K. and Miligkos, M. and Kaditis, A.G.",
    journal = "Pediatric Pulmonology",
    year = "2019",
    volume = "54",
    number = "10",
    pages = "1527-1533",
    publisher = "John Wiley and Sons Inc",
    issn = "8755-6863, 1099-0496",
    doi = "10.1002/ppul.24427",
    keywords = "C reactive protein, adenotonsillectomy;  Article;  body mass;  body weight gain;  child;  clinical effectiveness;  controlled study;  diastolic blood pressure;  Epworth sleepiness scale;  female;  human;  hypertrophy;  major clinical study;  male;  outcome assessment;  Pediatric Sleep Questionnaire sleep related breathing disorder scale;  postoperative period;  priority journal;  probability;  protein blood level;  pulse rate;  questionnaire;  rating scale;  school child;  scoring system;  sleep disordered breathing;  snoring;  systolic blood pressure;  tonsil disease;  tonsillar hypertrophy;  treatment outcome;  treatment response;  validity;  adenoidectomy;  preschool child;  randomized controlled trial;  sleep disordered breathing;  snoring;  tonsillectomy, Adenoidectomy;  Child;  Child, Preschool;  Female;  Humans;  Male;  Outcome Assessment, Health Care;  Postoperative Period;  Sleep Apnea Syndromes;  Snoring;  Surveys and Questionnaires;  Tonsillectomy",
    abstract = "Objective: To assess whether children with sleep-disordered breathing (SDB) symptom severity above a certain level, measured by a validated questionnaire, improve after adenotonsillectomy (AT) compared to no intervention. Methods: Children with snoring and tonsillar hypertrophy (4 to 10-years old), who were candidates for AT, were randomly assigned to two evaluation sequences (baseline and 3-month follow-up): (a) evaluation immediately before AT and at 3 months postoperatively (AT group); or (b) evaluation at the initial visit and at the end of the usual 3-month waiting period for surgery (control group). Outcomes were (a) Pediatric Sleep Questionnaire sleep-related breathing disorder scale (PSQ-SRBD); (b) modified Epworth Sleepiness Scale (mESS); and (c) proportion of subjects achieving PSQ-SRBD <0.33 (low-risk for apnea-hypopnea index ≥5/h) if they had score ≥0.33 at baseline. Results: Sixty-eight children were assigned to the AT and 72 to the control group and two-thirds of them had PSQ-SRBD ≥0.33. The AT group experienced significantly larger improvement between follow-up and baseline than controls (between-group difference [95% CI] for PSQ-SRBD: −0.31 [−0.35 to −0.27]; and mESS: −2.76 [−3.63 to −1.90]; P <.001 for both). Children with baseline PSQ-SRBD ≥0.33 in the AT group had an eight-times higher probability of achieving PSQ-SRBD <0.33 at follow-up than controls with similar baseline score (risk ratio [95% CI]: 8.33 [3.92-17.54]; P <.001). Conclusion: Among children with snoring, tonsillar hypertrophy, and clinical indications for AT, those with preoperative PSQ-SRBD score ≥0.33 show measurable clinical benefit postoperatively. © 2019 Wiley Periodicals, Inc."
}