Tonsillectomy in Adults over 40 Years of Age Does Not Increase the Risk of Pneumonia: A Three-Year Longitudinal Follow-Up Study

Abstract

To evaluate the effect of tonsillectomy on the subsequent risk of pneumonia in an adult population, a longitudinal follow-up case control study was conducted using a national health screening cohort dataset between 2003 and 2012. A total of 1005 tonsillectomy participants were 1:4 matched with 4020 control participants for age, sex, income, and region of residence. The number of pneumonia diagnoses were counted from the index date (ID) to the date after the first-year (post-ID 1y), second-year (post-ID 2y), and third-year (post-ID 3y) periods. Simple linear regression and multiple linear regression were conducted to calculate estimated values (EVs) and 95% confidence intervals for each post-ID pneumonia and compared between the two groups. Subgroup analyses were performed according to age, sex, and the number of pneumonia cases during the year prior to the ID (pre-ID 1y). In the simple linear regression model, post-ID pneumonia did not show a significant correlation with tonsillectomy (post-ID 1y: EV = 0.003; post-ID 2y: EV = 0.007; post-ID 3y: EV = 0.013; all p > 0.05). In the multiple regression model, post-ID pneumonia also did not show a significant correlation with tonsillectomy (post-ID 1y: EV = 0.001; post-ID 2y: EV = 0.006; post-ID 3y: EV = 0.011; all p > 0.05). In the subgroup analyses, tonsillectomy did not show a significant correlation with post-ID pneumonia in either the simple linear regression or multiple linear regression models (all p > 0.05). Tonsillectomy performed in the adult population did not show any effect in increasing the incidence of pneumonia during the first three postoperative years.

Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations

“…Several population-based studies have been performed to study the effects of tonsillectomy on later occurrences of other diseases. The risk of pneumonia after tonsillectomy in adults seems not to be increased ( 90 ), whereas the risk for later development of an autoimmune disease seems to be slightly increased ( 91 , 92 ). The list of studies investigating the risk of cancer after prior tonsillectomy seems to be larger: there is a slightly increased risk for breast cancer ( 93 , 94 ) and Hodgkin’s disease ( 95 ).…”

“…During the COVID-19 pandemic, it was speculated that patients who underwent a tonsillectomy might have a higher risk for a more severe course of the SARS-CoV2 infections (87,88). This has remained so far unproven (89). Several population-based studies have been performed to study the effects of tonsillectomy on later occurrences of other diseases.…”