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Twenty-year observational study of paediatric tonsillitis and tonsillectomy
Kate Hulse1, Ewan Lindsay2, Alexander Rogers3
1Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK kate.hulse@nhs.scot.
Archives of Disease in Childhood
|November 17, 2022
Summary
Fewer tonsillectomies were performed after new guidelines, but tonsillitis admissions rose, especially in deprived areas. Current tonsillectomy guidelines may harm children from lower socioeconomic backgrounds.
Area of Science:
- Otolaryngology
- Public Health
- Pediatrics
Background:
- Tonsillectomy indications in the UK have become more specific, leading to a decrease in procedures.
- Recurrent tonsillitis is primarily treated with tonsillectomy, raising concerns about potential increases in hospital admissions for tonsillitis and its complications.
Purpose of the Study:
- To assess trends in acute hospital admissions for tonsillitis in children under 16 in Scotland.
- To identify factors associated with tonsillectomy and tonsillitis admissions.
Main Methods:
- Utilized data from Scotland's Information Service Division (1996/1997–2016/2017) for individuals under 16.
- Employed Poisson regression and correlation analysis, considering socioeconomic status via the Scottish Index of Multiple Deprivation (SIMD).
Main Results:
- A significant drop in tonsillectomy rates followed the introduction of Scottish Intercollegiate Guidelines Network (SIGN) guidelines.
- Tonsillitis rates increased, though admissions were already rising; children from deprived areas were more likely to undergo tonsillectomy and be admitted for tonsillitis.
- Children from the most deprived areas showed a 72.0% higher likelihood of receiving a tonsillectomy.
Conclusions:
- Tonsillectomy and tonsillitis rates are highest in the most deprived populations.
- Potential contributing factors include antibiotic stewardship and challenges in accessing primary care.
- Current tonsillectomy guidelines may disproportionately negatively impact children from deprived households.
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