Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear.
Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB).
Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant.
Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores.
Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.
Objetivo: o estudo visa descrever e analisar a relação entre a cobertura da Estratégia Saúde da Família (ESF) e as Internações por Condições Sensíveis à Atenção Primária (ICSAP) em Anápolis no período de 2001 a 2017. Métodos: Estudo ecológico, descritivo e analítico. Considerou-se ICSAP ocorridas em Anápolis, no período de 2001 a 2017, analisando as referidas variáveis e suas interrelações. Os dados foram extraídos do Sistema de Informação Hospitalar (SIH/SUS) e do Sistema de Informação da Atenção Básica (SIAB). Foram ainda analisados por medidas de tendência central. As internações foram definidas por meio da Lista Brasileira de Internações por Condições Sensíveis à Atenção Primária. Resultados: A cobertura da ESF aumentou 5 vezes enquanto as ICSAP reduziram em 3 vezes em relação ao ano 2001. As etiologias mais prevalentes das ICSAP foram: Pneumonia, Gastroenterocolites, Asma, Insuficiência Cardíaca, Angina. O valor “r” atribuído à relação das afecções e as ESF foram negativos enquanto que apenas a pneumonia apresentou r=+0,37. A correlação entre ICSAP e ESF foi de -0,7, enquanto as Internações por Causas Não sensíveis à Atenção Primária (N-ICSAP) foi de +0,26. As gastroenterocolites representaram 76,26% das ICSAP. Angina e Insuficiência cardíaca predominaram em maiores de 60 anos. Asma representou 57,66% das internações em até 9 anos, enquanto a pneumonia mostrou-se prevalente em todas as faixas etárias. As mulheres internam cerca de 8 vezes mais que homens. Conclusões: O estudo concluiu que existe uma relação inversamente proporcional das ESF com as ICSAP no município de Anápolis.
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