%0 Journal Article
%T Does tonsillectomy reduce medical care visits for pharyngitis/tonsillitis in children and adults? Retrospective cohort study from Sweden
%A Eirik £¿stvoll
%A Joacim Stalfors
%A Ola Sunnergren
%J -
%D 2019
%R 10.1136/bmjopen-2019-033817
%X 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
%U https://bmjopen.bmj.com/content/9/11/e033817