| アブストラクト | OBJECTIVE: To investigate the effectiveness of tonsillectomy in reducing acute throat infection (ATI) consultation rates over 6 years' follow-up among children with low baseline ATI consultation rates. DESIGN: Retrospective cohort study. SETTING: UK general practices from the Clinical Practice Research Datalink. PARTICIPANTS: Children aged 4-15 years with </=3 ATI consultations during the 3 years prior to 2001 (baseline). 450 children who underwent tonsillectomy (tonsillectomy group) and 13 442 other children with an ATI consultation (comparison group) in 2001. MAIN OUTCOME MEASURES: Mean differences in ATI consultation rates over the first 3 years' and subsequent 3 years' follow-up compared with 3 years prior to 2001 (baseline); odds of >/=3 ATI consultations at the same time points. RESULTS: Among children in the tonsillectomy group, the 3-year mean ATI consultation rate decreased from 1.31 to 0.66 over the first 3 years' follow-up and further declined to 0.60 over the subsequent 3 years' follow-up period. Compared with children who had no operation, those who underwent tonsillectomy experienced a reduction in 3-year mean ATI consultations per child of 2.5 (95% CI 2.3 to 2.6, p<0.001) over the first 3 years' follow-up, but only 1.2 (95% CI 1.0 to 1.4, p<0.001) over the subsequent 3 years' follow-up compared with baseline, respectively. This equates to a mean reduction of 3.7 ATI consultations over a 6-year period and approximates to a mean annual reduction of 0.6 ATI consultations per child, per year, over 6 years' follow-up. Children who underwent tonsillectomy were also much less likely to experience >/=3 ATI consultations during the first 3 years' follow-up (adjusted OR=0.12, 95% CI 0.08 to 0.17) and the subsequent 3 years' follow-up (adjusted OR=0.24, 95% CI 0.14 to 0.41). CONCLUSIONS: Among children with low baseline ATI rates, there was a statistically significant reduction in ATI consultation rates over 6 years' follow-up. However, the relatively modest clinical benefit needs to be weighed against the potential risks and complications associated with surgery. |
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| ジャーナル名 | BMJ open |
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| 投稿日 | 2015/2/5 |
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| 投稿者 | Koshy, Elizabeth; Watt, Hilary; Curcin, Vasa; Bottle, Alex; Sharland, Mike; Saxena, Sonia |
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| 組織名 | Department of Primary Care and Public Health, Imperial College London, London,;UK.;Department of Primary Care and Public Health Sciences, Kings College London,;London, UK.;Paediatric Infectious Diseases Research Group, St George's University London, |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25649213/ |
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