%0 Journal Article
%T Tonsillectomy among children with low baseline acute throat infection consultation rates in UK general practices: a cohort study
%A Alex Bottle
%A Elizabeth Koshy
%A Hilary Watt
%A Mike Sharland
%A Sonia Saxena
%A Vasa Curcin
%J -
%D 2015
%R 10.1136/bmjopen-2014-006686
%X 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¨C15£¿years with ¡Ü3 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 ¡İ3 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 ¡İ3 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
%U https://bmjopen.bmj.com/content/5/2/e006686