Growth velocity predicts recurrence of sleep-disordered breathing 1 year after adenotonsillectomy

Raouf Amin, Leonard Anthony, Virend Somers, Matthew Fenchel, Keith McConnell, Jenny Jefferies, Paul Willging, Maninder Kalra, Stephen Daniels

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Abstract

Rationale: Adenotonsillectomy, the first line of treatment of sleepdisordered breathing (SDB), is the most commonly performed pediatric surgery. Predictors of the recurrence of SDB after adenotonsillectomy and its impact on cardiovascular risk factors have not been identified. Objectives: Demonstrate that gain velocity in body mass index (BMI) defined as unit increase in BMI/year confers an independent risk for the recurrence of SDB 1 year after adenotonsillectomy. Methods: Children with SDB and hypertrophy of the tonsils and a comparison group of healthy children were followed prospectively for 1 year. Measurements and Main Results: Serial polysomnographies, BMI, and blood pressure were obtained before adenotonsillectomy and 6 weeks, 6 months, and 1 year postoperatively. Gain velocity in BMI, BMI and being African American (odds ratios, 4-6/unit change/yr; 1.4/unit and 15, respectively) provided equal amounts of predictive power to the risk of recurrence of SDB. In the group that experienced recurrence, systolic blood pressure at 1 year was higher than at base line and higher than in children who did not experience recurrence. Conclusions: Three clinical parameters confer independent increased risk for high recurrence of SDB after adenotonsillectomy: gain velocity in BMI, obesity, and being African American. A long-term follow-up of children with SDB and monitoring of gain velocity in BMI are essential to identifying children at risk for recurrence of SDB and in turn at risk for hypertension.

Original languageEnglish (US)
Pages (from-to)654-659
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Volume177
Issue number6
DOIs
StatePublished - Mar 15 2008

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Keywords

  • Adenotonsillectomy
  • Growth velocity
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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