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ASSOCIATION OF ADENOTONSILLECTOMY WITH WHEEZING EPISODES IN CHILDHOOD: A SECONDARY ANALYSIS OF THE CHILDHOOD ADENOTONSILLECTOMY TRIAL
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  • Jose A. Castro Rodriguez ,
  • Andrea Beckhaus,
  • Fiorella Biancardi,
  • Ignacio Tapia
Jose A. Castro Rodriguez
Pontificia Universidad Catolica de Chile Escuela de Medicina

Corresponding Author:[email protected]

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Andrea Beckhaus
Pontificia Universidad Catolica de Chile Escuela de Medicina
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Fiorella Biancardi
Pontificia Universidad Catolica de Chile Escuela de Medicina
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Ignacio Tapia
University of Pennsylvania Perelman School of Medicine
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Abstract

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.
30 May 2022Submitted to Pediatric Pulmonology
16 Jun 2022Submission Checks Completed
16 Jun 2022Assigned to Editor
29 Jun 2022Reviewer(s) Assigned
15 Jul 2022Review(s) Completed, Editorial Evaluation Pending
17 Jul 2022Editorial Decision: Revise Major
20 Oct 20221st Revision Received
20 Oct 2022Review(s) Completed, Editorial Evaluation Pending
20 Oct 2022Submission Checks Completed
20 Oct 2022Assigned to Editor
20 Oct 2022Reviewer(s) Assigned
16 Nov 2022Editorial Decision: Accept