Correlations between objective and subjective outcomes after adenotonsillar surgery in children with OSA

Abstract

Abstract Objectives To investigate whether the OSA‐18 questionnaire and a postoperative patient‐reported outcome measure (PROM) question correlated with polysomnography (PSG) data. Methods A prospective study of otherwise healthy young children with moderate to severe obstructive sleep apnea (OSA) to investigate if the obstructive apnea–hypopnea index (OAHI) before and 6–12 months after adenotonsil surgery correlated with the OSA‐18 total symptom score (TSS) and the sleep disturbance subscale (SDS), as well as a PROM question on symptom improvement with responses on a 4‐grade Likert scale. Results Of 201 children, 173 (86%) had complete data of OAHI and OSA‐18 pre‐ and postoperatively. The mean age was 3.2 years (SD 1.0) and the mean OAHI was 15.9 (11.3). Significant correlations between changes in the OAHI and OSA‐18 were found, both TSS (r = 0.29, p < .001) and SDS (r = 0.53, p < .001). A total of 136 (68%) patients responded to the PROM question, the majority of whose symptoms had disappeared (n = 102) or almost disappeared (n = 30). Four patients had unchanged symptoms, and none had worsening symptoms. A correlation was found between the PROM question and a change in the OAHI (r = 0.36, p < .001), as well as a change in the OSA‐18 TSS (r = 0.24, p = .006) and the SDS (r = 0.34, p < .001). The specificity of the PROM question for prediction of a postoperative OAHI < 2 was 82%, and the sensitivity was 38%. Conclusion Changes in the OAHI significantly correlated with changes in the OSA‐18, especially with the sleep disturbance scale, which could be an alternative for evaluation at follow‐ups. Level of Evidence 3

Keywords

• adenotonsillectomy
• adenotonsillotomy
• pediatric obstructive sleep apnea
• polysomnography
• sleep‐disordered breathing