{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:53:34Z","timestamp":1785938014479,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T00:00:00Z","timestamp":1611014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the safety of paediatric tonsillectomy procedures conducted in NHS hospitals in England between 2008 and 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective observational cohort study using Hospital Episode Statistics (HES) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Acute NHS trusts in England conducting paediatric tonsillectomy procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Children (\u226416\u00a0years old) undergoing bilateral tonsillectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Number of tonsillectomies performed per year by procedural method. In\u2010hospital complications including return to theatre for arrest of haemorrhage. Readmission within 28\u00a0days, including those for pain, haemorrhage and surgical arrest of haemorrhage. Long\u2010term outcomes: all\u2010cause mortality, revision tonsillectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 318\u00a0453 paediatric tonsillectomies were performed from 2008 to 2019:278,772 dissection (87.5%) and 39\u00a0681 coblation (12.5%). The proportion of tonsillectomy performed using coblation increased from 7% in 2008\/9 to 27% in 2018\/9. Five patients died in hospital (including 4 due to respiratory complications). In\u2010hospital complications occurred in 4202 children (1.3%), with the most frequent being haemorrhage. Within 28\u00a0days of tonsillectomy, 28\u00a0170 patients (8.8%) were readmitted and 7 deaths occurred. Readmission rates for haemorrhage and pain have increased since 2008. The proportion of children undergoing revision tonsillectomy procedures within 5\u00a0years following coblation tonsillectomy (1.4%) was approximately double that of dissection (0.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clinical practice of paediatric tonsillectomy has changed in England over the past 11\u00a0years. The overall mortality rate associated with the procedure is 0.0037%. Differences in outcomes have been identified for different procedural methods. However, routine administrative data are limited in differentiating procedural detail (eg we are unable to differentiate intra or extra\u2010capsular techniques from current clinical coding of tonsillectomy procedures). Therefore, prospective national data collection or more granular clinical coding is essential to capture relative outcomes of the different tonsillectomy methods and techniques being used in the NHS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13707","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T08:35:47Z","timestamp":1609317347000},"page":"552-561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Paediatric tonsillectomy in England: A cohort study of clinical practice and outcomes using Hospital Episode Statistics data (2008\u20102019)"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5108-6279","authenticated-orcid":false,"given":"Kim","family":"Keltie","sequence":"first","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK"},{"name":"Translational and Clinical Research Institute Faculty of Medical Sciences University of Newcastle upon Tyne Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2676-7675","authenticated-orcid":false,"given":"Adam","family":"Donne","sequence":"additional","affiliation":[{"name":"Alder Hey Children\u2019s NHS Foundation Trust Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-6332","authenticated-orcid":false,"given":"Mat","family":"Daniel","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7061-1841","authenticated-orcid":false,"given":"Kate","family":"Stephenson","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kuo","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Saunders","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmal B.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Wrightington, Wigan and Leigh Teaching NHS Foundation Trust Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-3236","authenticated-orcid":false,"given":"Carl M.","family":"Philpott","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia Norwich UK"},{"name":"Norfolk &amp; Waveney ENT Service Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0831-4760","authenticated-orcid":false,"given":"Iain","family":"Bruce","sequence":"additional","affiliation":[{"name":"Royal Manchester Children\u2019s Hospital Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK"},{"name":"Division of Infection, Immunity and Respiratory Medicine Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8147-1549","authenticated-orcid":false,"given":"Matthew E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6591-5119","authenticated-orcid":false,"given":"John C.","family":"Hardman","sequence":"additional","affiliation":[{"name":"The Royal Marsden NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5418-3103","authenticated-orcid":false,"given":"Paola","family":"Cognigni","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley","family":"Richardson","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Gross","sequence":"additional","affiliation":[{"name":"NHS Digital Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9553-7278","authenticated-orcid":false,"given":"Andrew J.","family":"Sims","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK"},{"name":"Translational and Clinical Research Institute Faculty of Medical Sciences University of Newcastle upon Tyne Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7181-4608","authenticated-orcid":false,"given":"Steven","family":"Powell","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK"},{"name":"Population Health Sciences Institute Faculty of Medical Sciences University of Newcastle upon Tyne Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp18X699833"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/mlg.0b013e318031f0b0"},{"key":"e_1_2_11_4_1","unstructured":"The National Institute for Health and Care Excellence.Electrosurgery (diathermy and coblation for tonsillectomy. 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