Every year, hundreds of young children in Britain get an operation they do not need.
It is the conclusion of a study recently published in the British Journal of General Practice, conducted by a group of researchers at the University of Birmingham. The study showed that between 2005 and 2016, 88.3% of the children who received tonsillectomies in Britain did not meet the medical threshold for the procedure and it was unlikely to benefit from it.
Tonsillectomies are not risk-free
According to medical guidelines called Paradise Criteria, the American Academy of Otolaryngology and other major medical associations recommend that the children only get tonsillectomies if they suffer from at least seven throat throats the year before, at least five throat throats in the last two years, or at least three pain in throat in each of the previous three years. However, most child infants in Britain in recent years have been performed on children who did not buy these criteria.
University of Birmingham researchers came to this conclusion after analyzing the medical records of more than 1.6 million children from more than 700 British general practices within the country's Health Improvement Network (THIN) between 2005 and 2016. Of 18,271 children who had their tonsils removed During that period, only 2 144 (11.7%) had enough pain in the throat to motivate the operation.
It is worrying that even though tonsilloma tomography for children is common – the surgery is at risk of complications. According to a case study of Canadian health-related administrative data used by Birmingham researchers, 2.7% of children who receive tonsil tumors are reported within 30 days and 12.4% go to an emergency department. A 2014 review in Pediatrics showed that 7.8% of children undergoing tonsillectomies in the United States are returning to the hospital with complications within 30 days. And another study showed the most common causes of withdrawal, including excessive bleeding, acute pain, fever, vomiting and dehydration.
Even when the children qualify for the procedure, parents can consider a "vigilant wait" strategy, according to Nicholas Balakar in The New York Times. It is because, while tonsillectomy may be useful for children who are severely affected, a new study of more than 60,000 Danish children shows that the procedure is associated with a much higher risk of upper respiratory disease.
The risks of unnecessary operations for children
Tragic but unusual cases, like 13-year-old Jahi McMath's death after a tonsillectomy 2013, have emphasized the importance of the children just passing through the operations they actually need. According to the Pacific Standard Magazine, "America dies every year thousands of children due to dubious medical interventions and poor follow-up."
Unnecessary surgical procedures also pose a burden on public health systems. For example, in the United Kingdom, the National Health Service (NHS) performed approximately 37,000 child benefits from April 2016 to March 2017, at a cost of 42 million pounds.
A national health assessment of the Birmingham study considered it correct but clarified that digital records do not always reflect the reasons for recommending tonsillectomy, which means that there might be other reasons why physicians chose to continue the surgery in specific cases.
Tom Marshall, a study author and public health professor at the University of Birmingham, says it's more likely that his team overestimated rather than underestimated the number of throat throats that children had before surgery because they used a broad definition of what constituted a tonsil, or sore throat caused by infected tonsils. But even after performing the analysis with a stricter definition of throat throat, researchers found that it was "still true that most children with frequent pain in the throat do not have their tonsils removed", according to Marshall.
Birmingham researchers also noted that among British children like did meeting the criteria for tonsillectomy and had seven or more severe sore throats within one year, only 14% actually received the surgery. Marshall says that this prompted him to wonder if "children may be more injured than a tonsillectomy".
"We found that even among hard-hit children only a small minority ever has their tonsils," he said. "It makes you wonder about tonsillectomy [is] ever really important in all children. "