A 20-year observational cohort of a 5 million patient population-Tonsillectomy rates in the context of two national policy changes
A 20-year observational cohort of a 5 million patient population-Tonsillectomy rates in the context of two national policy changes
复制标题
DOI：
10.1111/coa.13233
复制
发表时间：
2019-01-01
影响因子：
2.1
通讯作者：
Clark, Louise J.
中科院分区：
文献类型：
--
作者：
Douglas, Catriona M.;Altmyer, Ursula;Clark, Louise J.
目的：（a）报告二级保健中扁桃体切除术、扁桃体炎、扁桃体周围脓肿和颈深间隙感染的国家趋势。(b)报告初级保健中咽喉痛咨询的国家趋势。(c)报告2011年至2015年期间初级和二级医疗中抗生素处方的全国趋势。设计：回顾性全国队列研究。苏格兰信息统计部（ISD）要求提供1993/94年至2015/16年期间苏格兰扁桃体切除术、扁桃体炎入院、扁桃体周围脓肿入院和颈深间隙感染（DNSI）入院的数据。2011年至2015年期间全科医生和住院患者抗生素处方数据。设置：苏格兰耳鼻喉科和全科医生实践。参与者：接受扁桃体切除术或因扁桃体炎、扁桃体周围脓肿或深颈间隙感染入院的苏格兰患者。结果：1993/94年至2015/16年期间，扁桃体切除率下降了48%（P <0. 001）。在同一时期，扁桃体炎的入院率相应增加了136%（P < 0.001），扁桃体周围脓肿的入院率增加了167%（P < 0.001）。在1996/97年至2015/16年期间，深颈间隙扩张增加了500%（P < 0.001）。结论：在过去的二十年中，扁桃体切除率显著下降。在同一时期，因扁桃体炎、扁桃体周围脓肿和深颈间隙感染而接受二级护理的人数显著增加。这些变化发生在两个独立的国家政策正在引入的背景下-苏格兰校际指南网络（SIGN）管理咽喉痛的指南和苏格兰减少抗生素处方。
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.