Every year, hundreds of young children in the UK are given unnecessary surgery.
This is the conclusion of a study recently published in the British Journal of General Practice, conducted by a team of researchers at the University of Birmingham. The study found that between 2005 and 2016, 88.3% of children receiving almonds in the UK did not meet the medical limit for the procedure and were unlikely to take advantage of it.
Tonsillectomy is not without risk
According to the medical guidelines known as Paradise criteria, the American Academy of Otorhinolaryngology and other major medical associations recommend that children only get smokers if they suffer from at least seven coughs in the past year, at least five coughs in the last two years, or at least three coughs in each of the past three years. But most childhood tonsillectomy in the United Kingdom in recent years has been done in children who did not bring meat to these criteria.
Researchers at Birmingham University concluded this conclusion after analyzing the medical records of more than 1.6 million children from over 700 UK general practices in the THIN health improvement network between 2005 and 2016. Of these, 18,271 children who had their tonsils removed at the time, only 2,144 (11.7%) had enough sore throats to justify taking the surgery.
This is worrying because – although almonds for children are accustomed – surgery comes with complications of complications. According to a case study of Canadian health data used by Birmingham researchers, 2.7% of children receiving almonds are re-injected within 30 days and 12.4% go to emergency department. A Review for 2014 at Pediatrics showed that 7.8% of children undergoing tonsillectomy in the US ended up in the hospital with complications within 30 days. And another study showed that the most common causes of re-admission were excessive bleeding, acute pain, fever, vomiting and dehydration.
Even when children qualify for the process, parents may want to look at a "cautious wait" strategy, according to Nicholas Balakar in the New York Times. This is due to the fact that while tonsillectomy may be beneficial for seriously affected children, a recent study of over 60,000 Danish children showed that the process is associated with a much higher risk of upper respiratory disease.
The risks of unnecessary surgical procedures for children
Tragically but not unusual incidents, such as the 13-year-old Jahi McMath's death following a tonsillectomy in 2013, have highlighted the importance of ensuring that children only go through the surgical procedures they really need. According to Pacific Standard Magazine, "every year in America, thousands of children die because of questionable medical procedures and poor monitoring."
Unnecessary surgeries are also a burden on public health systems: In the United Kingdom, for example, the National Health Service (NHS) made about 37,000 childhood almonds from April 2016 to March 2017 at a cost of 42 million pounds.
An analysis of the National Health Service of the Birmingham study found it to be accurate, but clarified that digital medical records do not always reflect the reasons why tonsillectomy is recommended – which means there are other reasons why doctors choose to go ahead surgery in specific cases.
Tom Marshall, author of the study and professor of public health at Birmingham University, says his team is more likely to overestimate than to underestimate the number of sore throats that had children prior to surgery, as they used a broad definition of what it recommended tonsillitis, or sore throat caused by infected tonsils. However, even after the analysis with a more severe definition of the sore throat, the researchers found that "it is still true that the vast majority of children with frequent sore throats have not removed their tonsils," Marshall said.
Birmingham researchers also noted that among the children of the United Kingdom who I did met the criteria for tonsillectomy and had seven or more severe sore throats within a year, only 14% actually took surgery. Marshall says this made him wonder if "children can harm more than being helped by a tonsillectomy."
"We found that even among severely affected children, only a small minority of women ever have their tonsils out," he said. "It makes you wonder if the tonsillectomy [is] never really meaningful to any child. "