{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:58:59Z","timestamp":1785776339759,"version":"3.56.0"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterise adult tonsillectomy procedures conducted in the NHS from routine administrative data in England and investigate trends in their associated complications over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational cohort study using routine data from Hospital Episode Statistics (HES).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Acute NHS trusts in England are conducting adult tonsillectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults (&gt;\u200916\u2009years old) undergoing tonsillectomy procedure with a primary diagnosis of any non\u2010malignant indication, and with no current or historic cancer, or benign neoplasm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Number of procedures, in\u2010hospital complications, readmissions within 28\u2009days and trends over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 198\u2009130 adult patients had a tonsillectomy between 1 April 2008 and 31st March 2023 in NHS trusts in England. The total number of procedures is falling over time. It is more commonly undertaken in women (68.3%), with 79.3% performed for tonsillitis. The majority (59.6%) are discharged on the same day, with 37.5% staying 1 night in hospital. 1.5% of patients had an in\u2010hospital complication, with a total of 1967 patients having a haemorrhage or surgical arrest of post\u2010operative bleeding from the tonsillar bed or adenoid; occurring more frequently in men (1.7% versus 0.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A total of 33\u2009934 patients were readmitted as an emergency within 28\u2009days of surgery, almost doubling between 2008\/09 and 2022\/23. Readmission with bleeding within 28\u2009days has also increased from 8.8% in 2008\/09 to 15.6% in 2022\/23. The return to theatre rate during readmissions has been relatively stable over the study time period with a higher proportion of admissions being managed without a further operative procedure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tonsillectomy is a very common operation in the NHS in England. It currently has a readmission rate of 1 in 5 adults and this information is important for informed consent and local resource planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70130","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:34:26Z","timestamp":1780706066000},"page":"744-751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tonsillectomy Complications in Adults: A Retrospective Observational Cohort Study of National Health Service Patients in England Using Hospital Episode Statistics"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7181-4608","authenticated-orcid":false,"given":"Steven","family":"Powell","sequence":"first","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5108-6279","authenticated-orcid":false,"given":"Kim","family":"Keltie","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\/0009-0008-5447-593X","authenticated-orcid":false,"given":"Ed","family":"O'Toole","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2544-9827","authenticated-orcid":false,"given":"Rachel A.","family":"O'Leary","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"}]},{"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0873-6878","authenticated-orcid":false,"given":"Rosalyn","family":"Parker","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4096-3296","authenticated-orcid":false,"given":"James","family":"O'Hara","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-2324","authenticated-orcid":false,"given":"Benjamin","family":"Talks","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2676-7675","authenticated-orcid":false,"given":"Adam","family":"Donne","sequence":"additional","affiliation":[{"name":"Alder Hey Children's NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Stafford","sequence":"additional","affiliation":[{"name":"South Tyneside and Sunderland NHS Foundation Trust  Sunderland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9436-7326","authenticated-orcid":false,"given":"Andrew C.","family":"Swift","sequence":"additional","affiliation":[{"name":"Liverpool University Hospitals NHS Foundation Trust  Liverpool 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"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"NHS Digital \u201cHospital Admitted Patient Care Activity 2019\u201320: Procedures and Intervention \u201daccessed May 26 2025 https:\/\/files.digital.nhs.uk\/FA\/DA0567\/hosp\u2010epis\u2010stat\u2010admi\u2010proc\u20102021\u201022\u2010tab.xlsx."},{"key":"e_1_2_11_3_1","unstructured":"\u201cThe Royal College of Surgeons of England. National Prospective Tonsillectomy Audit Final Report 2005 \u201daccessed September 26 2025 https:\/\/www.rcseng.ac.uk\/\u2010\/media\/files\/rcs\/library\u2010and\u2010publications\/non\u2010journal\u2010publications\/national\u2010prospective\u2010tonsillectomy\u2010audit\u2010final\u2010report\u20102005.pdf."},{"key":"e_1_2_11_4_1","unstructured":"\u201cGetting It Right First Time. Ear Nose and Throat Surgery November 2019 \u201daccessed September 26 2025 https:\/\/gettingitrightfirsttime.co.uk\/wp\u2010content\/uploads\/2019\/12\/ENT\u2010Report\u2010Nov19\u2010M.pdf."},{"key":"e_1_2_11_5_1","unstructured":"NHS England \u201cModel Health System \u201daccessed September 26 2025 https:\/\/model.nhs.uk\/."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13707"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7462.369"},{"key":"e_1_2_11_8_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2023"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2007.09.005"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2018.0034"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010014\u20103431\u20106"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010019\u201005509\u20102"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2020.7030"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2020.1746396"},{"issue":"8","key":"e_1_2_11_15_1","article-title":"Incidence of Post\u2010Tonsillectomy Haemorrhaging in Denmark","volume":"67","author":"Juul M. 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