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Weight gain after adenotonsillectomy: a case control study
Travis L Lewis1, Romaine F Johnson2, Jonathan Choi3
1Department of Otolaryngology, Head and Neck Surgery, University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas, USA travis.lewis@phhs.org.
Insights
Adenotonsillectomy (T&A) is associated with significant weight gain in obese children, but not in normal-weight or overweight children. Pre-T&A weight reduction counseling is recommended for obese children.
Area of Science:
- Pediatric Endocrinology
- Otolaryngology
- Obesity Medicine
Background:
- Adenotonsillectomy (T&A) is a common surgical procedure in children.
- The association between T&A and subsequent weight changes requires further investigation.
Purpose of the Study:
- To investigate the relationship between adenotonsillectomy and weight gain in pediatric patients.
- To determine if T&A influences weight trajectory across different BMI categories.
Main Methods:
- Retrospective case-control study involving 154 children who underwent T&A and 182 controls.
- Weight and height were tracked at 6-month intervals for 24 months post-procedure.
- Analysis utilized multilevel mixed-effects regression, stratifying by normal weight, overweight, and obese categories.
Main Results:
- Children undergoing T&A showed increased weight gain compared to controls at all intervals.
- Obese children who had T&A gained significantly more weight (4.2 kg difference at 24 months) than obese controls.
- No significant weight or height differences were observed in normal-weight or overweight groups post-T&A.
Conclusions:
- Adenotonsillectomy is linked to substantial weight gain specifically in obese children.
- Weight reduction counseling should be considered for obese children prior to undergoing T&A.
Objective:
To study the association between adenotonsillectomy (T&A) and weight gain in children.
Study Design:
Retrospective case-control series.
Setting:
Tertiary academic children's medical center.
Subjects And Methods:
A total of 154 children who underwent T&A at a tertiary care children's hospital between December 2010 and March 2011 were included. They were compared with 182 children with similar demographics who were seen in primary care clinics at the same institution (control group). Height and weight were compared at 6-month intervals over a 24-month period. Patients were divided into normal weight, overweight, and obese. A multilevel mixed-effects regression model was used for analysis. Significance was set at P ≤ .05.
Results:
Children who underwent T&A gained more weight than controls at every interval. At 24 months, they gained an additional 2.6 kg (confidence interval [CI], 0.9-3.9) but were an additional 1.8 cm (CI, 0.1-3.5) taller. There was no difference in weight gain at 6 months for obese children. At 12, 18, and 24 months, the obese group outgained the control group. At 24 months, the obese T&A group had gained an average of 14.3 kg, while the control had gained 10.1 kg, for a difference of 4.2 kg (CI, 1.3-6.1) with no difference in height changes. There were no differences in weight or height changes for the normal-weight and overweight groups at the conclusion of the study.
Conclusions:
T&A leads to a significant increase in weight in obese but not normal-weight or overweight children. Efforts should be made to provide weight reduction counseling prior to T&A in obese children.
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