A nationwide registry‐based cohort study of incidence of tonsillectomy in Denmark, 1991‐2012

Abstract

Objective: To update tonsillectomy incidence rates in Denmark and identify whether the incidence rates vary between geographical areas in the country during the period 1991-2012.Design: This was a retrospective nationwide cohort study using data from the comprehensive Danish patient registries. Data included surgical code, gender and date of birth, date and place of surgery.Setting: Hospitals and private oto-, rhino-, laryngology (ORL) offices.Participants: Danes who underwent tonsillectomy in the period 1991-2012.Main outcome measure: Tonsillectomy.Results: In the 22-year period, 177 211 tonsillectomies were conducted, and the overall incidence of tonsillectomy decreased significantly over time. The overall annual incidence of tonsillectomies decreased from 155.7 per 100 000 inhabitants in 1991 to 129.4 per 100 000 inhabitants in 2012. In 1991, 5.5% of tonsillectomies were performed in office settings, while in 2012, it had increased to 26.6% (P < .01). The highest incidence of tonsillectomy was found in children between 3 and 4 years of age (predominance of males, P < .01) and in 15-to 19-year-olds (predominance of females, P < .01). Each year, 0.44% of children underwent tonsillectomy, and by the age of 20, 7.7% of the Danish people has had a tonsillectomy. There were significant regional differences in the number of tonsillectomies. Conclusion:The incidence rate of tonsillectomies in Denmark decreased significantly in the study period, but with great regional variance.

An epidemiological study of paediatric adenotonsillectomy in Victoria, Australia, 2010‐2015: Changing indications and lack of effect of hospital volume on inter‐hospital transfers

“…This discrepancy may be explained by our inclusion of patients up to age 19 years with a higher proportion of females in the over 15 years age group, consistent with evidence that adolescent females experience more upper respiratory tract infections than males . Procedures were also more common in children aged under 10 years, consistent with previous studies . This age represents the peak prevalence of both upper respiratory tract infections and oSDB …”

“…14 Procedures were also more common in children aged under 10 years, consistent with previous studies. 6,8 This age represents the peak prevalence of both upper respiratory tract infections and oSDB. 15,16 In Victoria, children of higher socioeconomic status (quintiles 4…”

“…However, there have been limited multicentre studies dedicated to describing the epidemiology of adenotonsillectomy in North America, Europe, Asia and Africa, and none in Australia. These studies identified variation in adenotonsillectomy rates, specifically between age groups, sexes and socioeconomic status . Epidemiological data outside of Australia have described a recent increase in adenotonsillectomy rates, concurrent with the rise in surgical treatment for oSDB …”

“…In particular, the relationship between volume of cases per hospital and complication rates provide data that are useful to inform health policy. However, there have been limited multicentre studies dedicated to describing the epidemiology of adenotonsillectomy in North America, 4,5 Europe, 6,7 Asia 8 and Africa, 9 and none in Australia. These studies identified variation in adenotonsillectomy rates, specifically between age groups, 4-8 sexes 4-8 and socioeconomic status.…”

Factors associated with changing indications for adenotonsillectomy: A population-based longitudinal study

“…The variation in adenotonsillectomy (AT) rates across different countries may be explained in part by the different cultural attitudes toward the protective role of these lymphoepithelial structures [ 8 , 9 ], use of antibiotics for throat infections, and absence of generally accepted indication criteria for surgery [ 10 , 11 ]. A 22-year nationwide cohort showed a significant decrease in the incidence of tonsillectomy over time [ 12 ]; however, regional variations were observed in the number of tonsillectomies. Following the introduction of a national clinical guideline for the management of sore throat and indications for tonsillectomy, Mcleod et al reported a probable association between an increase in admissions with tonsillitis or peritonsillar abscess and a decrease in the rate of tonsillectomy [ 13 ].…”