Pan-Scotland tonsillectomy outcomes: A national cross-sectional study

Area of Science:

• Otolaryngology
• Surgical Outcomes Research
• Public Health

Background:

• Tonsillectomy is a common surgical procedure with potential complications such as post-operative hemorrhage.
• Monitoring surgical outcomes like hemorrhage and re-admission rates is crucial for patient safety and healthcare quality.

Purpose of the Study:

• To assess current post-tonsillectomy hemorrhage, re-admission, and return to theatre rates in Scotland.
• To compare these rates between two distinct time periods (1998-2002 and 2013-2017).

Main Methods:

• A national cross-sectional study utilizing retrospective data from Information Services Division (ISD) Scotland.
• Analysis of 30-day re-admission and return to theatre rates for all NHS patients undergoing tonsillectomy between 1998-2002 and 2013-2017.
• Validation of data through comparison with a regional audit.

Main Results:

• Tonsillectomy rates showed a decrease from 27,819 patients (1998-2002) to 23,184 patients (2013-2017).
• Significant increases in 30-day re-admission rates were observed: from 4.7% to 12.1% in pediatric patients and 9.8% to 19.9% in adult patients.
• 30-day return to theatre rates also increased: from 1.2% to 1.7% in pediatric patients and 3.6% to 4.9% in adult patients.

Conclusions:

• Current post-tonsillectomy hemorrhage rates are higher than previously reported series.
• The rising rates are likely multifactorial, potentially due to underestimation of historical rates and changes in patient demographics.
• These findings highlight the need for auditing current practices and have implications for patient consent and ENT service provision.