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Does tonsillectomy reduce medical care visits for pharyngitis/tonsillitis in children and adults?: Retrospective cohort study from Sweden
Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp, Sweden.
Univ Gothenburg, Sweden; Sheikh Khalifa Med City, U Arab Emirates.
2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 11, article id e033817Article in journal (Refereed) Published
Abstract [en]

Objective To assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis.

Design Retrospective cohort study.

Setting Data were retrieved from the VEGA register, a comprehensive regional cohort in Sweden.

Participants 1044 children (<15 years) and 2244 adults.

Intervention Tonsillectomy/adenotonsillectomy compared with no surgical treatment.

Main outcome measures Changes in yearly mean rates of medical care visits due to pharyngitis/tonsillitis.

Results In children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of −1.80 (−1.90 to −1.69), p<0.0001. In patients who did not undergo surgery, the corresponding mean change was −1.51 (−1.61 to −1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of −0.283 (−0.436 to −0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of −1.30 (−1.36 to −1.24), p<0.0001, compared with −1.18 (−1.24 to −1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was −0.111 (−0.195 to −0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up.

Conclusion In this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019. Vol. 9, no 11, article id e033817
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-164411DOI: 10.1136/bmjopen-2019-033817ISI: 000512774800389PubMedID: 31719097Scopus ID: 2-s2.0-85074911910OAI: oai:DiVA.org:liu-164411DiVA, id: diva2:1415766
Note

Funding Agencies|health care region Vastra Gotaland; Gothenburg Society of Medicine and Acta Oto-Laryngologica

Available from: 2020-03-19 Created: 2020-03-19 Last updated: 2020-04-15Bibliographically approved

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