Abstract
ObjectiveTo assess whether increased awareness and diagnosis of obstructive sleep apnoea syndrome (OSAS) and national guidance on tonsillectomy for recurrent tonsillitis have influenced the socio-demographic profile of children who underwent tonsillectomy over the last decade.MethodRetrospective time-trends study of Hospital Episodes Statistics data. We examined the age, sex and deprivation level, alongside OSAS diagnoses, among children aged <16 years who underwent (adeno)tonsillectomy in England between 2001/2 and 2011/12.ResultsAmong children aged <16 years, there were 29,697 and 27,732 (adeno)tonsillectomies performed in 2001/2 and 2011/12, respectively. The median age at (adeno)tonsillectomy decreased from 7 (IQR: 5–11) to 5 (IQR: 4–9) years over the decade. (Adeno)tonsillectomy rates among children aged 4–15 years decreased by 14% from 350 (95%CI: 346–354) in 2001/2 to 300 (95%CI: 296–303) per 100,000 children in 2011/12. However, (adeno)tonsillectomy rates among children aged <4 years increased by 58% from 135 (95%CI: 131–140) to 213 (95%CI 208–219) per 100,000 children in 2001/2 and 2011/2, respectively. OSAS diagnoses among children aged <4 years who underwent surgery increased from 18% to 39% between these study years and the proportion of children aged <4 years with OSAS from the most deprived areas increased from 5% to 12%, respectively.Conclusions(Adeno)tonsillectomy rates declined among children aged 4–15 years, which reflects national guidelines recommending the restriction of the operation to children with more severe recurrent throat infections. However, (adeno)tonsillectomy rates among pre-school children substantially increased over the past decade and one in five children undergoing the operation was aged <4 years in 2011/12.The increase in surgery rates in younger children is likely to have been driven by increased awareness and detection of OSAS, particularly among children from the most deprived areas.
Highlights
Conclusions: (Adeno)tonsillectomy rates declined among children aged 4–15 years, which reflects national guidelines recommending the restriction of the operation to children with more severe recurrent throat infections
The overalltonsillectomy rate among children aged,16 years was 300 per 100,000 children in 2001/2 and declined to 277 per 100,000 in 2011/12. (Adeno)tonsillectomy rates among children aged,4 years increased by 58% from 135 to 213 per 100,000 children in 2001/2 and 2011/2, respectively (Figure 1)
By contrast,tonsillectomy rates among children aged 4–15 years decreased by 14% from 350 to 300 per 100,000 children (Figure 1)
Summary
Conclusions: (Adeno)tonsillectomy rates declined among children aged 4–15 years, which reflects national guidelines recommending the restriction of the operation to children with more severe recurrent throat infections. (adeno)tonsillectomy rates among pre-school children substantially increased over the past decade and one in five children undergoing the operation was aged ,4 years in 2011/12.The increase in surgery rates in younger children is likely to have been driven by increased awareness and detection of OSAS, among children from the most deprived areas
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