Abstract
This study aimed to investigate the occurrence of tonsillectomy in asthmatic children using a control group with a comparable frequency of a preoperative history of asthma. Asthmatic children ≤15 years old were collected from the Korean Health Insurance Review and Assessment Service - National Sample Cohort (HIRA-NSC) from 2002 through 2013. In study I, asthmatic children who had undergone a tonsillectomy (n = 2,326) and control I participants (n = 9,304) were selected and matched 1:4 for age, sex, income, and region of residence but not a preoperative history of asthma. In study II, a preoperative history of asthma was additionally matched for between the tonsillectomy (n = 2,280) and the new control II participants (n = 9,120). The margin of equivalence of difference (control-tonsillectomy) for asthma was set at −0.05 to 0.05 per year. In addition, repeated measures ANOVA was performed for tonsillectomy according to yearly changes in asthma, status asthmaticus, and admission. In study I, the preoperative frequencies of asthma, status asthmaticus, and admission were higher in the tonsillectomy group than in the control group (P ≤ 0.001). The frequencies of postoperative asthma, status asthmaticus, and admission were lower in the tonsillectomy group than in the control I group for 3 years. In study II, the frequencies of postoperative 1-, 2-, and 3-year asthma and admission were not lower in the tonsillectomy group than in the control II group. Tonsillectomy did not further reduce the frequency of asthma in patients who underwent this procedure compared to the control group when a preoperative history of asthma history was equally matched between the two groups.
Highlights
Asthma is one of the most common chronic diseases in pediatric and adult populations[1]
The frequency of preoperative and postoperative 1- and 2-year admission were higher in the tonsillectomy group than in the control I group
Control II groups, the frequency of postoperative 2-year status asthmaticus was lower in the tonsillectomy group than in the control II group (0.00 ± 0.06 for the tonsillectomy group vs. 0.01 ± 0.21 for the control II group, 95% confidence interval (CI) of differences = 0.00 to 0.01; Table 3)
Summary
Asthma is one of the most common chronic diseases in pediatric and adult populations[1]. Several previous studies have suggested that upper airway inflammation, for instance tonsillar hypertrophy, may be influence the development of asthma[7,8,9]. A recent systemic review reported a consistent correlation between tonsillectomy in asthmatic children and alleviated symptoms and parameters of asthma[7]. Tonsillar hypertrophy is another common condition in children. In study I, the control group was matched for age, sex, income, and region of residence, as in previous studies In addition to these demographic factors,a preoperative history of asthma was matched between the new control group and the study group in study II. All asthma-related parameters were investigated for a follow-up periods up to 3 years
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