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Najafi A, Ala M, Amali A, Hivechi N, Heidari R, Mokary Y. An Evaluation of Obstructive Sleep Apnea Patient's Quality of life Following Continuous Positive Airway Pressure and Uvulopalatopharyngoplasty. Indian J Otolaryngol Head Neck Surg 2024; 76:753-757. [PMID: 38440610 PMCID: PMC10908904 DOI: 10.1007/s12070-023-04270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/05/2023] [Indexed: 03/06/2024] Open
Abstract
Aims Obstructive sleep apnea (OSA) is characterized by episodic sleep state-dependent upper airway collapse. OSA can markedly decrease quality of life (QoL) and productivity. Continuous Positive Airway Pressure (CPAP) has been used as an effective treatment for OSA. Recently, uvulopalatopharyngoplasty (UPPP) treatment has emerged as effective management among patients with OSA, especially non-adherent ones to conventional therapies such as CPAP. Our aim was to determine whether CPAP and UPPP treatment could improve the quality of life in patients with moderate OSA. Design Prospective. Setting Patients with moderate OSA, confirmed by polysomnography from March 2019 to March 2020, participated. CPAP and UPPP treatments were considered for patients according to their preferences. The Sleep Apnea Quality of Life Index (SAQLI) questionnaire before and after treatment was completed. Methods Change in their QoL was compared between the CPAP group and UPPP treatment. In addition, QoL was compared between these groups and patients who did not receive any of these treatment methods. Results Seventy-eight patients were included in treatment groups, 40 using CPAP and 38 undergoing UPPP treatment. Furthermore, 10 patients who did not receive treatment were considered the control. Both methods of treatment significantly (p < 0.001) improved QoL, but UPPP treatment was superior (p = 0.042) to CPAP. There was a poor correlation between post-treatment BMI (0.037), Respiratory Disturbance Index (RDI) (0.096), age (0.022), and post-treatment SAQLI score. Conclusion Based on these results, CPAP and UPPP treatment can improve QoL. UPPP treatment could be considered an effective arm of OSA management among the study population.
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Affiliation(s)
- Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Moin Ala
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Amin Amali
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Hivechi
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Reihaneh Heidari
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mokary
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Locci C, Cenere C, Sotgiu G, Puci MV, Saderi L, Rizzo D, Bussu F, Antonucci R. Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome: Clinical and Functional Outcomes. J Clin Med 2023; 12:5826. [PMID: 37762766 PMCID: PMC10531828 DOI: 10.3390/jcm12185826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/27/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Adenotonsillectomy (AT) is the first-line treatment for pediatric obstructive sleep apnea syndrome (OSAS). Relatively few studies have evaluated the clinical and functional outcomes of AT in children with OSAS, but these studies show that surgery improves behavior and quality of life (QOL). However, residual OSAS after AT is reported in severe cases. This study aimed to retrospectively evaluate the clinical and functional outcomes of AT in a cohort of children with OSAS. We consecutively enrolled children with OSAS who underwent AT and were admitted to our clinic from 1 July 2020 to 31 December 2022. For each participant, medical history and physical examinations were performed. Before and after surgery, all patients underwent a standard polygraphic evaluation, and caregivers completed the OSA-18 questionnaire. A total of 65 children with OSAS, aged 2-9 years, were included. After AT, 64 (98.4%) children showed a reduction in AHI, with median (IQR) values decreasing from 13.4/h (8.3-18.5/h) to 2.4/h (1.8-3.1/h) (p-value < 0.0001). Conversely, median (IQR) SpO2 nadir increased after surgery from 89% (84-92%) to 94% (93-95%) (p-value < 0.0001). Moreover, 27 children (18%) showed residual OSAS. The OSA-18 score decreased after AT from median (IQR) values of 84 (76-91) to values of 33 (26-44) (p-value < 0.0001). A positive significant correlation was found between OSA-18 post-operative scores and AHI post-operative scores (rho 0.31; p-value = 0.01). Our findings indicate that, in children with OSAS, AT is associated with significant improvements in behavior, QOL, and polygraphic parameters. However, long-term post-surgical follow-up to monitor for residual OSAS is highly recommended, especially in more severe cases.
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Affiliation(s)
- Cristian Locci
- Pediatric Clinic, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Caterina Cenere
- Pediatric Clinic, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Mariangela Valentina Puci
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Davide Rizzo
- Otorhinolaryngology Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Francesco Bussu
- Otorhinolaryngology Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Roberto Antonucci
- Pediatric Clinic, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
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Decreased clinic visits for acute respiratory infections following an adult tonsillectomy: A population-based study. Am J Otolaryngol 2017; 38:488-491. [PMID: 28502371 DOI: 10.1016/j.amjoto.2017.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 04/24/2017] [Accepted: 05/05/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE This study attempted to investigate the effects of a tonsillectomy on utilization of medical resources for acute respiratory infections by comparing numbers and costs of clinic visits within 1year before and after a tonsillectomy. MATERIALS AND METHODS Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. The study includes 481 patients aged 18-80years who underwent a tonsillectomy and 481 comparison patients. A multivariate regression model employing difference-in-difference was carried out to assess the independent association between a tonsillectomy and the number and costs of clinic visits. RESULTS We found that for patients who underwent a tonsillectomy, the mean number of clinic visits for acute respiratory care 1year before and after the index date significantly decreased from 7.3 to 4.2 (p<0.001). However, for the comparison group, there was no significant difference in the number (p=0.540) or costs (p=0.221) of clinic visits for acute respiratory care 1year before and after the index date. A multivariate regression model revealed that a tonsillectomy was associated with a reduction of 3.38 in the mean number of clinic visits for acute respiratory care (p<0.001). In other words, a tonsillectomy reduced by 46.3% (3.38/7.3) the number of clinic visits for acute respiratory care after adjusting for sociodemographic characteristics and medical comorbidities compared to comparison patients. CONCLUSIONS This study demonstrated that a tonsillectomy was of substantial benefit to adult patients in that it provides decreased healthcare utilization for acute respiratory infections.
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Cognitive Event-Related Potentials in Patients With Adenoid Hypertrophy: A Case-Control Pilot Study. J Clin Neurophysiol 2016; 33:443-449. [PMID: 26808619 DOI: 10.1097/wnp.0000000000000258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Children with adenoid hypertrophy commonly have sleep-disordered breathing. Sleep-disordered breathing is associated with various neurocognitive problems. The aim of this study was to assess the cognitive function in those patients using cognitive event-related potentials. METHODS Twenty-three patients with moderate to severe adenoid hypertrophy were compared with 20 healthy controls. The intelligence quotient was performed for all study participants. The latencies of the N200, P300 peaks and the amplitudes of the N200/P300 components of event-related potentials were recorded. The above variables were measured at baseline for both patients and control groups and 2 months after adenoidectomy for the patient group. RESULTS There was no significant difference between patients and controls regarding full intelligence quotient scales. P300 latency was significantly prolonged in patient group compared with the healthy controls. Moreover, postoperative P300 latency was significantly reduced compared with the preoperative P300 latency. Postoperative P300 latency was not statistically different from healthy controls' data. CONCLUSIONS P300 latency delay may reflect some sort of cognitive impairment in patients with adenoid hypertrophy. This delay was reversible after adenoidectomy. Event-related potentials may help for assessment of cognitive functions in patients with adenoid hypertrophy.
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Lee CH, Kang KT, Weng WC, Lee PL, Hsu WC. Quality of life after adenotonsillectomy in children with obstructive sleep apnea: short-term and long-term results. Int J Pediatr Otorhinolaryngol 2015; 79:210-5. [PMID: 25555637 DOI: 10.1016/j.ijporl.2014.12.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/04/2014] [Accepted: 12/09/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess short-term and long-term changes in quality of life after adenotonsillectomy (T&A) in children with obstructive sleep apnea (OSA). MATERIALS AND METHODS Children aged 2-18 years old were enrolled. All subjects had clinical symptoms, overnight polysomnography diagnosis of OSA, and received T&A as treatment. Caregivers were asked to complete the OSA-18 survey before surgery, within 6 months after surgery (short-term), and more than 6 months after surgery (long-term). RESULTS A total of 114 children were included (mean age, 7.0±3.5 years; 75% boys). The mean OSA-18 total score was 71.5±16.0 before surgery. After surgery, the mean OSA-18 total score was significantly decreased in both the short-term (40.3±12.2, p<0.001) and the long-term (42.0±13.7, p<0.001). All five OSA-18 domains were also significantly decreased during short-term and long-term postoperative follow up (p<0.001). Short-term and long-term outcomes were compared. Mean OSA-18 total scores, sleep disturbance score, emotional distress score, daytime function score, and caregiver concerns score did not differ significantly between the short-term and long-term periods, while the physical symptom score was slightly higher in the long-term than the short-term period (9.7±3.3 vs. 8.7±3.0, p=0.02). Additionally, the physical symptoms score was higher in the long-term period in the female (p=0.01), older age (>6 years) (p=0.03), and non-obese (p=0.04) subgroups. CONCLUSION T&A improves short-term and long-term quality of life in children with OSA. Nevertheless, caregivers observed children with aggravation of physical symptoms of quality of life during long-term follow up, especially in the female, older, and non-obese subgroups.
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Affiliation(s)
- Chia-Hsuan Lee
- Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan
| | - Kun-Tai Kang
- Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan; Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Chin Weng
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Lin Lee
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Chung Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan; Sleep Center, National Taiwan University Hospital, Taipei, Taiwan.
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Lachanas VA, Mousailidis GK, Skoulakis CE, Papandreou N, Exarchos S, Alexopoulos EI, Bizakis JG. Validation of the Greek OSD-6 quality of life questionnaire in children undergoing polysomnography. Int J Pediatr Otorhinolaryngol 2014; 78:1342-7. [PMID: 24927640 DOI: 10.1016/j.ijporl.2014.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 05/14/2014] [Accepted: 05/20/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE OSD-6 is a disease specific questionnaire for pediatric obstructive sleep apnea (OSA). The aims of this study were to validate OSD-6 in Greek language and correlate OSD-6 with polysomnography results. STUDY DESIGN Prospective study. SETTING Tertiary referral center. SUBJECTS AND METHODS OSD-6 questionnaire was translated to Greek and back to English. A prospective study was conducted on children undergoing overnight polysomnography due to snoring and disrupted sleep. Test-retest evaluation was carried out. Internal consistency and test-retest reliability were evaluated. Validity was assessed by exploring correlations between OSD-6 scores and apnea-hypopnea index (AHI), and by comparing total scores of OSA and non-OSA groups. Responsiveness was assessed by comparing preoperative to postoperative total scores in OSA children who underwent adenotonsillectomy. RESULTS Test-retest evaluation of 91 subjects showed good internal consistency (Cronbach's alpha 0.860 for test and 0.873 for retest) and reliability (Pearson's correlation coefficients between test and retest scores: 0.751-0.546; p<0.01). Total and domains' OSD-6 scores and AHI were significantly correlated (Spearman's correlation coefficients: 0.277-0.630; p<0.01), while children with OSA had higher total OSD-6 score than those without OSA (median (interquartile range): 16 (11) vs. 10 (7), respectively; p<0.01), indicating good validity. Postoperative OSD-6 scores were significantly lower than preoperative (2.84 ± 3.21 vs. 15.42 ± 6.48, respectively; p<0.001), suggesting good responsiveness. CONCLUSION The Greek version of the OSD-6 questionnaire proved to be a valid instrument with satisfactory internal consistency, reliability, validity and responsiveness. Furthermore, in our study OSD-6 was significantly correlated to polysomnography results.
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Affiliation(s)
| | | | | | | | - Sotirios Exarchos
- Department of Otorhinolaryngology, University Hospital of Larissa, Greece
| | | | - John G Bizakis
- Department of Otorhinolaryngology, University Hospital of Larissa, Greece
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Kang KT, Weng WC, Lee CH, Lee PL, Hsu WC. Discrepancy between Objective and Subjective Outcomes after Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome. Otolaryngol Head Neck Surg 2014; 151:150-8. [DOI: 10.1177/0194599814529534] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 03/07/2014] [Indexed: 11/16/2022]
Abstract
Objective Adenotonsillectomy (T&A) is the first line therapy for pediatric obstructive sleep apnea (OSA); however, inconsistency between objective and subjective outcomes perplexes physicians. This study investigates changes of objective and subjective outcomes in children with OSA after T&A, in particular, to elucidate correlations and discrepancies between these 2 measures. Study Design Case series with record review. Setting Tertiary referral medical center. Subjects and Methods Symptomatic children with polysomnographic diagnosis of OSA (apnea-hypopnea index [AHI] > 1) were included. All children underwent T&A to treat OSA, along with completely objective (polysomnography) and subjective (Obstructive Sleep Apnea 18-Item Quality-of-Life Questionnaire [OSA-18]) measures before and 3 months after surgery. Results One hundred nineteen children were included (mean age, 6.9 ± 3.3 years; 76% boys). Adenotonsillectomy significantly reduced AHI from 15.4 ± 21.2 per hour to 1.6 ± 2.5 per hour ( P < .001). The OSA-18 scores were significantly improved after surgery ( P < .001). A weak but statistically significant positive correlation was found between AHI and OSA-18 scores preoperatively (ρ = 0.22, P = .016) but not postoperatively (ρ = 0.04, P = .677). Among those cases with residual OSA after surgery, only 6% (3/54) had a residual effect on quality of life (OSA-18 score > 60). Conclusion Adenotonsillectomy improves both objective and subjective outcomes. After surgery, quality of life significantly improved subjectively, despite an incomplete resolution of OSA objectively, leading to a better correlation between objective and subjective measures before as opposed to after surgery. Discrepancy between the 2 measures warrants an evaluation of a child both objectively and subjectively when treating OSA.
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Affiliation(s)
- Kun-Tai Kang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wen-Chin Weng
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hsuan Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Otolaryngology, China Medical University Hospital, Taipei Branch, Taiwan
| | - Pei-Lin Lee
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Chung Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
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Tsou YA, Lin CC, Lai CH, Wang CY, Lin CD, Chen PC, Tsai IJ, Chen CM, Sung FC, Tsai MH. Does Adenotonsillectomy really reduced clinic visits for pediatric upper respiratory tract infections? A national database study in Taiwan. Int J Pediatr Otorhinolaryngol 2013; 77:677-81. [PMID: 23394793 DOI: 10.1016/j.ijporl.2013.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 01/07/2013] [Accepted: 01/12/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate whether adenotonsillectomy reduces upper respiratory tract infections (URIs) in the pediatric population. METHODS AND SUBJECTS We identified 415 children, aged ≤18 years who had undergone adenoidectomy and/or tonsillectomy during the period from 1999 to 2006, from the Taiwan National Health Insurance Research Database. The comparison group consisted of 1630 children without the surgery randomly selected from the same database frequency matched with sex, age and the surgery date (index date). Changes in physician visits for URIs 2-year period before and 2-year period after the index date were compared between the two groups of children. RESULTS The number of outpatient visits for URIs decreased with time, children with tonsillectomy and/or adenoidectomy had a greater reduction than comparison children (mean changes, -14 times and -6 times, respectively) in the 2-year period after the index date. Multivariate analyses using generalized estimated equation revealed a significant effect in reducing URIs visits from the surgery (relative ratio=0.85, p<0.0001), strongest for children undergoing both tonsillectomy and adenoidectomy (relative ratio=0.76, p<0.0001). The association between surgery and the decrease in URIs was more pronounced for children aged 12 years and less. CONCLUSION This population-based study suggests that tonsillectomy and/or adenoidectomy is associated with fewer physician visits for URIs. The association is weakened in old children.
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Affiliation(s)
- Yung-An Tsou
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
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Kaditis A, Kheirandish-Gozal L, Gozal D. Algorithm for the diagnosis and treatment of pediatric OSA: A proposal of two pediatric sleep centers. Sleep Med 2012; 13:217-27. [DOI: 10.1016/j.sleep.2011.09.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 09/04/2011] [Accepted: 09/07/2011] [Indexed: 01/28/2023]
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Rajmil L, Roizen M, Psy AU, Hidalgo-Rasmussen C, Fernández G, Dapueto JJ. Health-related quality of life measurement in children and adolescents in Ibero-American countries, 2000 to 2010. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2012; 15:312-322. [PMID: 22433763 DOI: 10.1016/j.jval.2011.11.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 10/19/2011] [Accepted: 11/11/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To analyze the characteristics of instruments designed to assess the health-related quality of life (HRQOL) in children, developed or adapted from 2000 to 2010 in Argentina, Chile, Mexico, Spain, and Uruguay. METHODS The protocol-led literature review included database searching (e.g., Medline, ISI Science Citation Index) and manual searching to retrieve studies focused on measures of HRQOL, health status, or well-being addressed to children and adolescents. Country-specific filters were applied to identify studies carried out in the participating countries. The characteristics of the instruments and type of studies were analyzed. Descriptive characteristics and psychometric properties were analyzed following the guidelines of the Scientific Advisory Committee of the Medical Outcomes Trust. RESULTS Ninety-nine documents were included. Thirty-one questionnaires were identified, 24 instruments were adapted, and the psychometric properties of 20 HRQOL instruments were reported in the study period. There was substantial variability in the number and characteristics of the dimensions included. Reliability was generally acceptable, and the majority of instruments provided data on internal consistency (n = 18) and, to a lesser extent, on test-retest reliability (n = 12). Nearly all studies reported construct validity, but only four analyzed sensitivity to change. CONCLUSIONS There is a scarcity of instruments to measure HRQOL of children and adolescents in the countries analyzed. Certain psychometric characteristics have been reasonably well tested, but others, most notably sensitivity to change, have not been tested in most instruments. Extension of this study to other Latin American countries would help to further identify gaps in this area and promote the use of HRQOL measurement in children and adolescents in Spanish-speaking cultures.
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Affiliation(s)
- Luis Rajmil
- URSS, IMIM-Institut de Recerca Hospital del Mar, Barcelona, Spain.
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Naiboğlu B, Külekçi S, Kalaycık C, Sheidaei S, Toros SZ, Egeli E. Improvement in quality of life by adenotonsillectomy in children with adenotonsillar disease. Clin Otolaryngol 2011; 35:383-9. [PMID: 21108748 DOI: 10.1111/j.1749-4486.2010.02190.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the effect of adenotonsillectomy on quality of life of children with adenotonsillar disease and to evaluate the basal differences and post-surgical changes of life quality in children with different disease severity. STUDY DESIGN Prospective, case - controlled study. SETTING Tertiary referral center. PARTICIPANTS AND MAIN OUTCOME MEASURES Preoperative and postoperative quality of life of 40 children with adenotonsillar disease were determined by pedsQL™, and disease severity was assessed in terms of a score obtained by tonsil and adenoid health status instrument (TAHSI). These children comprised the study group. Median of scores of study group was 31. Twenty-one children with a score less than 31 comprised the study subgroup I, while 19 children with a score bigger than 31 comprised the study subgroup II. Thirty normal children comprised the control group. Comparisons of data obtained from affected and healthy children and their parents were made. RESULTS The mean preoperative physical, emotional, social, school and total quality of life scores of the study group were 64.81, 49.62, 76.37, 66.62 and 64.41; postoperatively 83.67, 75.75, 85.75, 87.25, 83.18; and control group were 82.21, 77.50, 92.50, 90.50, 85.40, respectively. There was highly statistically significant difference between all preoperative and postoperative scores of the study group. There was highly statistically significant difference between all preoperative scores of the study and control group. There was no statistically significant difference in preoperative and postoperative scores between the study subgroups. The improvement after surgery was not statistically significant between mild and severe group except for emotional scale. CONCLUSION Children with adenotonsillar disease showed significant improvements in disease-specific and global quality of life after adenotonsillectomy as measured by TAHSI and PedsQL. Preoperative and postoperative life quality does not differ according to severity of the disease. The improvement provided by adenotonsillectomy in the children with mild disease is statistically not different from the severely affected children in overall life quality.
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Affiliation(s)
- B Naiboğlu
- Department of Otolaryngology Head and Neck Surgery, Haydarpasa Numune Education and Research Hospital, Uskudar, İstanbul, Turkey.
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Development of a quality of life instrument for pediatric gastroesophageal reflux disease: qualitative interviews. J Pediatr Gastroenterol Nutr 2010; 50:486-92. [PMID: 20639705 DOI: 10.1097/mpg.0b013e3181b99ca6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Antireflux procedures (ARP) are commonly performed in children and there is no disease-specific quality of life (QOL) instrument for gastroesophageal reflux (GERD) in children. The aim of this study was to identify the relevant domains for developing such an instrument. These domains will be validated in a future study. PATIENTS AND METHODS Parents of 19 patients (age 2 months-18 years) clinically diagnosed with GERD were recruited to complete semistructured interviews. Seven patients with adequate verbal skills were also interviewed. Patients were treated medically (13 patients) or with an ARP (6 patients). The interviews were analyzed using grounded theory. RESULTS GERD affects QOL through the following domains: symptom severity, feeding quality, sleep quality, hygiene, growth and development, social quality, self-image, coping skills, family QOL, health care usage, and impact of ARP. A greater-than-expected effect on parental QOL and remarkable use of accommodation were identified. CONCLUSIONS A pediatric GERD-specific instrument cannot rely on QOL perception alone, but must address broadly the impact of the disease and the effect of coping skills on the child and his or her family in their activities of daily living and interaction with society. We have identified reproducible domains that will serve as the foundation for such an instrument.
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Improvement in quality of life after adenotonsillectomy in a child with Prader Willi syndrome. Sleep Breath 2009; 14:167-70. [PMID: 19763652 DOI: 10.1007/s11325-009-0297-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Accepted: 08/17/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We report a child with Prader Willi syndrome who developed obstructive sleep apnea (OSA). This patient underwent surgical treatment for OSA. There was improvement not only on her OSA but in her quality of life score as well. This report highlights the need for a comprehensive assessment in the management of patients with Prader Willi syndrome.
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Abstract
The consequences of poor quality and/or inadequate sleep in children and adolescents have become a major public health concern, and one in which pediatric health care professionals have become increasingly involved. In particular, insufficient and/or fragmented sleep resulting from primary sleep disorders such as obstructive sleep apnea (OSA), often compounded by the presence of comorbid sleep disorders as well as by voluntary sleep curtailment related to lifestyle and environmental factors, has been implicated in a host of negative consequences. These range from metabolic dysfunction and increased cardiovascular morbidity to impairments in mood and academic performance. The following review will focus on what is currently known about the effects of sleep disordered breathing (SDB) specifically on neurobehavioral and neurocognitive function in children. Because of the scarcity of literature on the cognitive and behavioral impact of sleep disorders in infants and very young children, this review will target largely the preschool/school-aged child and adolescent populations. In addition, the focus will be on a review of the most recent literature, as a supplement to several excellent previous reviews on the topic.
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Affiliation(s)
- Judith A Owens
- Department of Ambulatory Pediatrics, Rhode Island Hospital, Providence, Rhode Island 02903, USA.
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Gozal D, Sans Capdevila O, McLaughlin Crabtree V, Serpero LD, Witcher LA, Kheirandish-Gozal L. Plasma IGF-1 levels and cognitive dysfunction in children with obstructive sleep apnea. Sleep Med 2009; 10:167-73. [DOI: 10.1016/j.sleep.2008.01.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 12/26/2007] [Accepted: 01/03/2008] [Indexed: 01/21/2023]
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16
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Hibbs AM, Johnson NL, Rosen CL, Kirchner HL, Martin R, Storfer-Isser A, Redline S. Prenatal and neonatal risk factors for sleep disordered breathing in school-aged children born preterm. J Pediatr 2008; 153:176-82. [PMID: 18534222 PMCID: PMC2753386 DOI: 10.1016/j.jpeds.2008.01.040] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Revised: 11/09/2007] [Accepted: 01/30/2008] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Previously published data from the Cleveland Children's Sleep and Health Study demonstrated that preterm infants are especially vulnerable both to sleep disordered breathing (SDB) and its neurocognitive sequelae at age 8 to 11 years. In this analysis, we aimed to identify the components of the neonatal medical history associated with childhood SDB among children born prematurely. STUDY DESIGN This analysis focuses on the 383 children in the population-based cohort from the Cleveland Children's Sleep and Health Study who were born <37 weeks gestational age and who had technically acceptable sleep studies performed at ages 8 to 11 years (92% of all preterm children). Logistic regression was used to evaluate the associations between candidate perinatal and neonatal risk factors and the presence of childhood SDB by sleep study. RESULTS Twenty-eight preterm children (7.3%) met the definition for SDB at age 8 to 11 years. Having a single mother and mild maternal preeclampsia were strongly associated with SDB in unadjusted and race-adjusted models. Unadjusted analyses also identified xanthine use and cardiopulmonary resuscitation or intubation in the delivery room as potential risk-factors for SDB. We did not find a significant link between traditional markers of severity of neonatal illness-such as gestational age, birth weight, intraventricular hemorrhage, bronchopulmonary dysplasia, or duration of ventilation-and childhood SDB at school age. CONCLUSIONS These results represent a first step in identifying prenatal and neonatal characteristics that place preterm infants at higher risk for childhood SDB. The strong association between mild preeclampsia and childhood SDB underscores the importance of research aimed at understanding in utero risk factors for neurorespiratory development.
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Affiliation(s)
- Anna Maria Hibbs
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106-6010, USA.
| | - Nathan L Johnson
- Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Danville, PA
| | - Carol L Rosen
- Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Danville, PA
| | - H Lester Kirchner
- Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Danville, PA.,Geisinger Center for Health Research, Danville, PA
| | - Richard Martin
- Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Danville, PA
| | - Amy Storfer-Isser
- Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Danville, PA
| | - Susan Redline
- Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Danville, PA
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17
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Garetz SL. Behavior, cognition, and quality of life after adenotonsillectomy for pediatric sleep-disordered breathing: Summary of the literature. Otolaryngol Head Neck Surg 2008; 138:S19-26. [DOI: 10.1016/j.otohns.2007.06.738] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2007] [Accepted: 06/27/2007] [Indexed: 11/25/2022]
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18
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