A 20 year observational cohort of a 5 million patient population - tonsillectomy rates in the context of two national policy changes

C M Douglas, U Altmyer, L Cottom, D Young, P Redding, L J Clark

Research output: Contribution to journalArticle

Abstract

AIM: To report national trends for tonsillectomy, tonsillitis, peri-tonsillar abscess and deep neck space infection in secondary care. To report national trends in sore throat consultations in primary care. 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, peri-tonsillar 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 - 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 peri-tonsillar 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, peri-tonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced - SIGN guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing.
LanguageEnglish
Number of pages18
JournalClinical Otolaryngology
Early online date27 Sep 2018
DOIs
StateE-pub ahead of print - 27 Sep 2018

Fingerprint

Tonsillitis
Tonsillectomy
Antibiotics
Infection
Abscess
Neck
Secondary Care
Population
Pharyngitis
Scotland
Primary Care
Anti-Bacterial Agents
Cohort Study
P-space
Primary Health Care
Peritonsillar Abscess
Statistics
General Hospitals
General Practice
Decrease

Keywords

  • tonsillitis
  • tonsillectomy
  • deep neck space infection
  • per-tonsillar abscess
  • sore throat consultations

Cite this

@article{eadb7ae337df4882b320688bf54a25de,
title = "A 20 year observational cohort of a 5 million patient population - tonsillectomy rates in the context of two national policy changes",
abstract = "AIM: To report national trends for tonsillectomy, tonsillitis, peri-tonsillar abscess and deep neck space infection in secondary care. To report national trends in sore throat consultations in primary care. 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, peri-tonsillar 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 - 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 peri-tonsillar 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, peri-tonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced - SIGN guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing.",
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author = "Douglas, {C M} and U Altmyer and L Cottom and D Young and P Redding and Clark, {L J}",
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year = "2018",
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doi = "10.1111/coa.13233",
language = "English",
journal = "Clinical Otolaryngology",
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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. / Douglas, C M; Altmyer, U; Cottom, L; Young, D; Redding, P; Clark, L J.

In: Clinical Otolaryngology, 27.09.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A 20 year observational cohort of a 5 million patient population - tonsillectomy rates in the context of two national policy changes

AU - Douglas,C M

AU - Altmyer,U

AU - Cottom,L

AU - Young,D

AU - Redding,P

AU - Clark,L J

N1 - This article is protected by copyright. All rights reserved.

PY - 2018/9/27

Y1 - 2018/9/27

N2 - AIM: To report national trends for tonsillectomy, tonsillitis, peri-tonsillar abscess and deep neck space infection in secondary care. To report national trends in sore throat consultations in primary care. 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, peri-tonsillar 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 - 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 peri-tonsillar 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, peri-tonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced - SIGN guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing.

AB - AIM: To report national trends for tonsillectomy, tonsillitis, peri-tonsillar abscess and deep neck space infection in secondary care. To report national trends in sore throat consultations in primary care. 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, peri-tonsillar 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 - 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 peri-tonsillar 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, peri-tonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced - SIGN guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing.

KW - tonsillitis

KW - tonsillectomy

KW - deep neck space infection

KW - per-tonsillar abscess

KW - sore throat consultations

U2 - 10.1111/coa.13233

DO - 10.1111/coa.13233

M3 - Article

JO - Clinical Otolaryngology

T2 - Clinical Otolaryngology

JF - Clinical Otolaryngology

SN - 1749-4478

ER -