Ontology highlight
ABSTRACT: Objective
To investigate the effectiveness of tonsillectomy in reducing acute throat infection (ATI) consultation rates over 6?years' follow-up among children with low baseline ATI consultation rates.Design
Retrospective cohort study.Setting
UK general practices from the Clinical Practice Research Datalink.Participants
Children aged 4-15?years with ?3 ATI consultations during the 3?years prior to 2001 (baseline). 450 children who underwent tonsillectomy (tonsillectomy group) and 13?442 other children with an ATI consultation (comparison group) in 2001.Main outcome measures
Mean differences in ATI consultation rates over the first 3?years' and subsequent 3?years' follow-up compared with 3?years prior to 2001 (baseline); odds of ?3 ATI consultations at the same time points.Results
Among children in the tonsillectomy group, the 3-year mean ATI consultation rate decreased from 1.31 to 0.66 over the first 3?years' follow-up and further declined to 0.60 over the subsequent 3?years' follow-up period. Compared with children who had no operation, those who underwent tonsillectomy experienced a reduction in 3-year mean ATI consultations per child of 2.5 (95% CI 2.3 to 2.6, p<0.001) over the first 3?years' follow-up, but only 1.2 (95% CI 1.0 to 1.4, p<0.001) over the subsequent 3?years' follow-up compared with baseline, respectively. This equates to a mean reduction of 3.7 ATI consultations over a 6-year period and approximates to a mean annual reduction of 0.6 ATI consultations per child, per year, over 6?years' follow-up. Children who underwent tonsillectomy were also much less likely to experience ?3 ATI consultations during the first 3?years' follow-up (adjusted OR=0.12, 95% CI 0.08 to 0.17) and the subsequent 3?years' follow-up (adjusted OR=0.24, 95% CI 0.14 to 0.41).Conclusions
Among children with low baseline ATI rates, there was a statistically significant reduction in ATI consultation rates over 6?years' follow-up. However, the relatively modest clinical benefit needs to be weighed against the potential risks and complications associated with surgery.
SUBMITTER: Koshy E
PROVIDER: S-EPMC4322199 | biostudies-literature | 2015 Feb
REPOSITORIES: biostudies-literature
Koshy Elizabeth E Watt Hilary H Curcin Vasa V Bottle Alex A Sharland Mike M Saxena Sonia S
BMJ open 20150203 2
<h4>Objective</h4>To investigate the effectiveness of tonsillectomy in reducing acute throat infection (ATI) consultation rates over 6 years' follow-up among children with low baseline ATI consultation rates.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>UK general practices from the Clinical Practice Research Datalink.<h4>Participants</h4>Children aged 4-15 years with ≤3 ATI consultations during the 3 years prior to 2001 (baseline). 450 children who underwent tonsillectomy (tonsillec ...[more]