Josephine A Czechowicz1, Kay W Chang1. 1. Department of Otolaryngology-Head and Neck Surgery, Lucille Packard Children's Hospital, Stanford University School of Medicine, Stanford, California.
Abstract
IMPORTANCE: Several studies have documented that children gain more weight than expected after adenotonsillectomy. OBJECTIVES: To examine patterns of change in weight and stature percentiles in children after adenotonsillectomy and to analyze clinical and demographic correlates of shifts in the growth curve. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective medical record review, we studied patients 18 years and younger who underwent adenotonsillectomy at an academic pediatric tertiary medical center and had at least one height and weight measurement recorded at each of the following time points: within 3 months before surgery, within 3 to 9 months after surgery, and within 12 to 27 months after surgery. Data were procured from all children from January 1, 2007, through October 31, 2012, and initially included 2893 surgical patients and 161,458 height and weight measurements. The final database consisted of 815 patients with adequate growth data and multiple time points. Logistic regression analysis was performed to examine patient age at surgery, preoperative weight, sex, and ethnic background for correlations with changes in weight, height, and body mass index percentiles. MAIN OUTCOMES AND MEASURES: Change in weight, height, and body mass index percentile before and after surgery. RESULTS: At 18 months after surgery, weight percentiles in the study group increased by a mean of 6.3 percentile points (P < .001). Body mass index percentiles increased by a mean of 8.0 percentile points (P < .001). The greatest increases in weight percentiles were observed in children who were between the 1st and 60th percentiles for weight (P < .001) and younger than 4 years at the time of surgery (P < .001). An increase in weight percentile was not observed in children who preoperatively were already above the 80th percentile in weight (P = .15). CONCLUSIONS AND RELEVANCE: Weight gain after adenotonsillectomy occurs primarily in patients who are smaller and younger at the time of surgery and does not correlate with increased rates of obesity.
IMPORTANCE: Several studies have documented that children gain more weight than expected after adenotonsillectomy. OBJECTIVES: To examine patterns of change in weight and stature percentiles in children after adenotonsillectomy and to analyze clinical and demographic correlates of shifts in the growth curve. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective medical record review, we studied patients 18 years and younger who underwent adenotonsillectomy at an academic pediatric tertiary medical center and had at least one height and weight measurement recorded at each of the following time points: within 3 months before surgery, within 3 to 9 months after surgery, and within 12 to 27 months after surgery. Data were procured from all children from January 1, 2007, through October 31, 2012, and initially included 2893 surgical patients and 161,458 height and weight measurements. The final database consisted of 815 patients with adequate growth data and multiple time points. Logistic regression analysis was performed to examine patient age at surgery, preoperative weight, sex, and ethnic background for correlations with changes in weight, height, and body mass index percentiles. MAIN OUTCOMES AND MEASURES: Change in weight, height, and body mass index percentile before and after surgery. RESULTS: At 18 months after surgery, weight percentiles in the study group increased by a mean of 6.3 percentile points (P < .001). Body mass index percentiles increased by a mean of 8.0 percentile points (P < .001). The greatest increases in weight percentiles were observed in children who were between the 1st and 60th percentiles for weight (P < .001) and younger than 4 years at the time of surgery (P < .001). An increase in weight percentile was not observed in children who preoperatively were already above the 80th percentile in weight (P = .15). CONCLUSIONS AND RELEVANCE: Weight gain after adenotonsillectomy occurs primarily in patients who are smaller and younger at the time of surgery and does not correlate with increased rates of obesity.
Authors: Amanda G Ruiz; Dexiang Gao; David G Ingram; Francis Hickey; Matthew A Haemer; Norman R Friedman Journal: J Pediatr Date: 2019-05-10 Impact factor: 4.406