Changes in Body Mass Index Following Pediatric Tonsillectomy for Obstructive Sleep Apnea.

OBJECTIVE: The objective was to evaluate postoperative BMI trends (in kg/m²) in pediatric patients with obstructive sleep apnea (OSA) undergoing tonsillectomy by assessing BMI trends. STUDY DESIGN: This study was a retrospective chart review. SETTING: This review took place at a single-institution tertiary care center. METHODS: Eight hundred four pediatric patients who underwent tonsillectomy at Cooper University Hospital between January 2020 and January 2022 were grouped by preprocedure diagnosis of OSA. Patient age, sex, BMI (kg/m²) at baseline and at one-, three-, six-, and 12-month follow-ups, and postoperative pain metrics were collected. RESULTS: For all 804 patients aged 0 to 17 years old, there were significant increases in BMI values at one, three, six, and 12 months postoperatively from a baseline of 21.2 kg/m². BMI increased at one month postoperatively (difference = 0.46921 kg/m2 (0.02183-0.9165), p = 0.0399), three months (difference = 0.6858 kg/m2 (0.1738-1.1978), p = 0.0088), six months (difference = 1.0025 kg/m2 (0.359-1.646), p = 0.0023), and 12 months (difference = 1.4458 kg/m2 (0.8234-2.0682), p < 0.0001). Stratified by age, 274 (34%) patients aged 0 to four years old with OSA had no significant changes from a baseline BMI of 17 kg/m² at one or three months postoperatively. BMI increased at six months (difference = 0.8626 kg/m2 (0.1929-1.5324), p = 0.012) and at 12 months (difference = 1.0068 kg/m2 (0.3047-1.7089), p = 0.0052). Three hundred five (38%) patients aged five to nine years old with OSA had no significant changes from a baseline BMI of 20.2 kg/m² at one or six months postoperatively. BMI increased at three months (difference = 1.185 kg/m2 (0.03143-2.3386), p = 0.0441) and at 12 months (difference = 1.0398 kg/m2 (0.3658-1.7138), p = 0.0027). Two hundred twenty-five (28%) patients aged 10 to 17 years old with OSA had no significant changes from a baseline BMI of 28.2 kg/m² at one, three, or six months postoperatively. BMI increased at 12 months (difference = 2.5252 kg/m2 (0.769-4.2813), p = 0.0053). CONCLUSION: Tonsillectomy in pediatric patients with OSA is associated with significant postoperative BMI increases, highlighting the need for diagnosis-specific counseling and longitudinal weight monitoring.