Τίτλος:
Assessing the need for adenotonsillectomy for sleep-disordered breathing in a community setting: A secondary outcome measures analysis of a randomized controlled study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Papadakis, C.E.
Chaidas, K.
Chimona, T.S.
Zisoglou, M.
Ladias, A.
Proimos, E.K.
Miligkos, M.
Kaditis, A.G.
Περιοδικό:
Pediatric Pulmonology
Εκδότης:
John Wiley and Sons Inc
Λέξεις-κλειδιά:
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
