Does Adenotonsillectomy really reduced clinic visits for pediatric upper respiratory tract infections? A national database study in Taiwan

Objective: To investigate whether adenotonsillectomy reduces upper respiratory tract infections (URIs) in the pediatric population. Methods and subjects: We identified 415 children, aged ≤18 years who had undergone adenoidectomy and/or tonsillectomy during the period from 1999 to 2006, from the Taiwan National Health Insurance Research Database. The comparison group consisted of 1630 children without the surgery randomly selected from the same database frequency matched with sex, age and the surgery date (index date). Changes in physician visits for URIs 2-year period before and 2-year period after the index date were compared between the two groups of children. Results: The number of outpatient visits for URIs decreased with time, children with tonsillectomy and/or adenoidectomy had a greater reduction than comparison children (mean changes, -14 times and -6 times, respectively) in the 2-year period after the index date. Multivariate analyses using generalized estimated equation revealed a significant effect in reducing URIs visits from the surgery (relative ratio = 0.85, p< 0.0001), strongest for children undergoing both tonsillectomy and adenoidectomy (relative ratio = 0.76, p< 0.0001). The association between surgery and the decrease in URIs was more pronounced for children aged 12 years and less. Conclusion: This population-based study suggests that tonsillectomy and/or adenoidectomy is associated with fewer physician visits for URIs. The association is weakened in old children.