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A 20‐year observational cohort of a 5 million patient population—Tonsillectomy rates in the context of two national policy changes
Author(s) -
Douglas Catriona M.,
Altmyer Ursula,
Cottom Laura,
Young David,
Redding Penelope,
Clark Louise J.
Publication year - 2019
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13233
Subject(s) - peritonsillar abscess , medicine , tonsillectomy , tonsillitis , acute tonsillitis , sore throat , context (archaeology) , retrospective cohort study , pharyngitis , abscess , pediatrics , cohort , emergency medicine , surgery , paleontology , biology
Aim (a) To report national trends for tonsillectomy, tonsillitis, peritonsillar abscess and deep neck space infection in secondary care. (b) To report national trends in sore throat consultations in primary care. (c) To report national trends in antibiotic prescribing in both primary and secondary care between 2011 and 2015. Design Retrospective nationwide cohort study. Data requested from Information Statistics Department ( ISD ) Scotland for tonsillectomy, tonsillitis admissions, peritonsillar abscess admissions and deep neck space infection ( DNSI ) admissions in Scotland, between 1993/94 and 2015/16. Data for antibiotic prescriptions in general practice and hospital admissions between 2011 and 2015. Setting Scottish ENT departments and GP practices. Participants Scottish patients who underwent tonsillectomy or were admitted to hospital with tonsillitis, peritonsillar abscess or deep neck space infection. Scottish patients that attended their GP with tonsillitis. Results Tonsillectomy rates between 1993/94 and 2015/16 decreased by 48% ( P < 0.001). Over the same time period, there has been a corresponding 136% increase in tonsillitis admission ( P < 0.001) and a 167% increase in peritonsillar abscess admissions, ( P < 0.001). Between 1996/97 and 2015/16, there was a 500% increase in deep neck space abscesses ( P < 0.001). Conclusion There has been a significant decrease in tonsillectomy rates over the past two decades. Over the same time period, there has been a significant increase in admissions to secondary care with tonsillitis, peritonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced—Scottish Intercollegiate Guideline Network (SIGN) guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing.