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

Abstract

ObjectiveAdenotonsillectomy (AT) is one of the most common surgical procedures performed in children and adults. We aim to assess the factors associated with changes in the incidence of and indications for AT using population-level data.Study designThis retrospective cohort study investigated patients who underwent AT between 1997 and 2010 by using data from the Taiwan National Health Insurance Research Database. We examined surgical rates and indications by the calendar year as well as age, sex, hospital level, and insured residence areas for the correlating factors.ResultsThe average annual incidence rate of AT was 14.7 per 100,000 individuals during 1997–2010. Pediatric (<18 years) patients represented 48.2% of the total AT population. More than 99% of the patients underwent the AT procedures as an inpatient intervention. Longitudinal data demonstrated an increasing trend in the pediatric AT rates from 1997 (4.3/100,000) to 2010 (5.7/100,000) (p = 0.029). In the adult subgroup, a decreasing prevalence of infectious indications (p = 0.014) coincided with an increasing neoplastic indications (p = 0.001). In the pediatric subgroup, the prevalence of obstructive indications increased (p = 0.002). The logistic regression analyses indicated that the significant factors associated with the changing surgical indications for AT were the age in the adult subgroup and hospital level in the pediatric subgroup.ConclusionsThis study revealed a low AT rate in Taiwan than that in other countries. Pediatric AT incidence increased during 1997–2010. Although a rising prevalence of obstructive and neoplastic indications was noted, infection remained the most common indications for AT. Age in the adult subgroup and hospital level in the pediatric subgroup were factors associated with the changing indications for AT.

Awareness and Perceptions of the Impact of Tonsillectomy on the Level of Immunity and Autoimmune Diseases among the Adult Population in Abha City, Kingdom of Saudi Arabia

“…Tonsillectomy was found to be common among school-going children who were mostly in middle school (57.9%), whereas a study conducted in Australia, by Tran AH et al, showed a high prevalence of tonsillectomy among children 5–9 years of age [ 17 ]. Around 39.2% of patients with tonsillectomy have a family income of up to 9000 SAR, suggesting a lower middle class, which is also supported by research showing that twice as many children with age <16 years belong to the lower socioeconomic class [ 11 , 18 , 19 ]. However, household income showed a weak association with tonsillectomy in many other studies [ 20 , 21 ].…”

Incidence of Late-Onset Psoriasis Following Tonsillectomy: A Longitudinal Follow-Up Study Using a National Health Screening Cohort

“…Second, the indications for tonsillectomy were not explicitly confirmed, and it is uncertain whether the procedure was performed due to tonsillitis. However, it is well-documented that tonsillectomy is predominantly conducted to address the infectious complication of tonsillitis, and previous studies have indicated that treatment for recurrent infections or chronic inflammation is the most common reason for tonsillectomy across all age groups [ 26 ]. Third, since information on different types of psoriasis, such as guttate, inverse, pustular, erythrodermic, or plaque, was unavailable in our dataset, types of psoriasis were not specifically categorized and were included into one group overall.…”

The application of xylocaine 10% pump-spray to improve immediate post-adenotonsillectomy pain in children: A randomized controlled trial

“…We noted the strongest benefit to pain control in the younger children rather than in older children, who are known to struggle with pain after adenotonsillectomy. Most of the children in our trial were admitted for recurrent tonsillitis, which is the most common indication for adenotonsillectomy in children younger than 18 years old [18].…”