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

Sung Joon Park,Sei Young Lee,Hyo Geun Choi,Dae Myoung Yoo,Chanyang Min

doi:10.3390/ijerph182413059

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.

Highlights

SAS version 9.4 (SAS Institute Inc., Cary, NC, USA) was used for statistical analyses. Compared to those of the tonsillectomy group, the age, sex, income, and region of residence-matched control group did not show any significant difference in any covariates, and obesity (0.36) and Charlson Comorbidity Index (CCI) (0.22) showed the top two standardized differences (Table 1)
Significance at p < 0.05. † Model stratified by age, sex, income, and region of residence. ‡ Model adjusted for obesity, smoking, alcohol consumption, total cholesterol, SBP, DBP, fasting blood glucose, CCI scores, asthma, COPD, and pre-index date (ID) pneumonia for 1y. In this longitudinal case–control study using a national cohort dataset between 2003 and 2012, the tonsillectomy group did not show a significant correlation with the incidence of pneumonia during the first three postoperative years when compared to the control group
The tonsillectomy group did not show a significant association with the incidence of pneumonia during the three studied postoperative years, regardless of age, sex, or history of pre-ID 1y pneumonia

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Tonsillectomy is one of the most commonly performed operations in both children [1]. It has been reported that the rate of tonsillectomy is. 3.4 to 4.8 per 1000 people in the U.S [3,4] and 2.58 per 1000 people in Korea [5,6]. It was reported in 2006 that 297,000 tonsillectomies were performed in adults out of 737,000 total tonsillectomies in the U.S [2]

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Discussion

Conclusion