ASSOCIATION OF ADENOTONSILLECTOMY WITH WHEEZING EPISODES IN CHILDHOOD: A
SECONDARY ANALYSIS OF THE CHILDHOOD ADENOTONSILLECTOMY TRIAL
Background: Observational studies suggest that asthma/wheezing
improve after adenotonsillectomy (AT). However, there is a paucity of
RCT specifically studying the effects of AT in asthma/wheezing.
Therefore, we conducted a post-hoc analysis of the Childhood
Adenotonsillectomy Trial, the largest RCT of AT in children with
obstructive sleep apnea (OSA) to test the hypothesis that AT would
result in fewer wheezing episodes. Methods: In the CHAT study,
464 children with OSA, aged 5 to 9 years, were randomized to early AT
(n=226) or watchful waiting with supportive care (WWSC) (n= 227). For
this post-hoc analysis children were categorized as having “any
wheezing” vs. “no wheezing” at baseline and at 7 months of follow-up.
A multivariate analysis was conducted to evaluate the association
between “any wheezing” at follow-up and treatment group after
controlling for several potential confounders. Results:
Children in the “any wheezing” group were predominantly black, had
more allergic rhinitis, eczema, second-hand smoke exposure, more
siblings and siblings with asthma, lower maternal education and family
income than those in the “no wheezing group”. At baseline, wheezing
characteristics were similar between AT and WWSC arms. At follow-up (at
7 months of the intervention) those in the AT arm had significatively
less wheezing than those in the WWSC (22.4% vs. 43.8%, p=0.00001).
However, the multivariate analysis of “any wheezing” vs. “no
wheezing” at follow-up showed that the treatment arm was not associated
with wheezing. Conclusion: This study demonstrated that AT has
not effect on wheezing at 7 months of follow-up.