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’ followup.
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.