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Am J Respir Crit Care Med. 2008 Mar 15;177(6):654-9. doi: 10.1164/rccm.200710-1610OC. Epub 2008 Jan 3.

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

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  • 1Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. raouf.amin@cchmc.org

Abstract

RATIONALE:

Adenotonsillectomy, the first line of treatment of sleep-disordered 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 baseline 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.

PMID:
18174542
[PubMed - indexed for MEDLINE]
PMCID:
PMC2267339
Free PMC Article
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