Clinical indicators that predict the presence of moderate to severe obstructive sleep apnea after adenotonsillectomy in children

Bharat Bhushan, Stephen Sheldon, Edward Wang, James W. Schroeder*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

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. Study Design Retrospective study. Setting 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. Main outcome measures 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. Conclusion 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.

Original languageEnglish (US)
Pages (from-to)487-495
Number of pages9
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume35
Issue number4
DOIs
StatePublished - 2014

ASJC Scopus subject areas

  • Otorhinolaryngology

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