Every year, hundreds of young children in the United Kingdom are getting surgery that they do not need. That's the…
Every year, hundreds of young children in the United Kingdom are getting surgery that they do not need.
That’s 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 found that, between 2005 and 2016, 88.3% of the kids who had tonsillectomies in the UK did not meet the medical threshold for the procedure, and were unlikely to benefit from it.
The University of Birmingham researchers came to this conclusion after analyzing the medical records of over 1
.6 million children from more than 700 UK general practices in the country’s Health Improvement Network (THIN) between 2005 and 2016. Out of 18,271 children who had their tonsils removed during that period, only 2,144 (11.7%) had enough sore throats to justify getting the surgery.
That’s worrisome because -Although tonsillectomies for kids are commonplace-the surgery comes with risks of complications. Ifølge et studie om canadiske sundhedsdata fra Birmingham, 2,7% af børnene som modtager tonsillektomier, er readmitted inden for 30 dage, og 12,4% går til en nøddepartement. A 2014 review in Pediatrics showed that 7.8% of children who undergo tonsillectomies in the US end up back at the hospital with complications within 30 days. And another study showed the most common causes of readmission were excessive bleeding, acute pain, fever, vomiting, and dehydration.
Even when kids qualify for the procedure, parents may want to consider a strategy of “watchful waiting” Nicholas Balakar in The New York Times. Det er fordi, mens tonsillektomi kan være gavnligt for børn som er alvorligt påvirket, en nylig undersøgelse af mere end 60.000 danske børn viste at proceduren er forbundet med en langt højere risiko for sygdomme i det øvre luftvejsområde.
Tragic, but uncommon cases, like the death of 13-year-old Jahi McMath following a tonsillectomy in 2013, have highlighted the importance of ensuring that kids only go through surgeries they actually need. Ifølge Pacific Standard Magazine, “hvert år i Amerika, tusinder af børn som døde på grund af tvivlsomme medicinske interventioner og dårlig opfølgning.”
Unnecessary surgical procedures also represent a burden on public health systems: In the UK, for example, The National Health Service (NHS) performed approximately 37,000 childhood tonsillectomies from April 2016 to March 2017 at a cost of £ 42 million.
An National Health Service analysis of the Birmingham study considered it accurate, but clarified that digital medical records do not ‘t always reflect the reasons why a tonsillectomy is recommended-meaning that it’s possible there were other reasons why doctors chose to go ahead with surgery in specific cases.
Tom Marshall, en studieforfatter og professor i folkesundhed ved University of Birmingham, says it is more likely that his team overestimated rather than underestimated the number of sore throats children had before surgery, since they used a broad defi nition of what constituted a tonsillitis, or sore throat caused by infected tonsils. Men, efter at have udført analysen med en strengere definition af en sår throat, fandt forskerne at det var “stadig sandt at det store flertallet af børn med hyppige sårede throats ikke har deres tonsils fjernet,” ifølge Marshall.
The Birmingham researchers also noted that among UK children who did measured the criteria for tonsillectomies and had seven or more severe aches within a year, only 14% actually received the surgery. Marshall says this made him wonder if “children may be more harmed than helped by tonsillectomy.”
“We found that even among severely affected children only a tiny minority of ever had their tonsils out,” he said. “It makes you wonder if tonsillectomy [is] ever really essential in any child. “