Adenotonsillectomy linked to more RTI visits

The findings suggest adenotonsillectomy should not be performed solely to prevent respiratory tract infections in pediatric patients.

To assess the association between adenotonsillectomy and hospital visits for respiratory tract infections (RTIs) in pediatric patients.

Study Design: A retrospective nationwide cohort study using Korean National Health Insurance Service data from 2010 to 2017.
Participants: Included 6,848 pediatric patients who underwent adenotonsillectomy and 34,240 matched nonsurgical controls.
Data Analysis: RTI-related hospital visits were assessed during the year prior to surgery and each of the 3 postoperative years, using International Classification of Diseases codes.

Patients who underwent adenotonsillectomy had higher odds of acute upper RTI-related visits during postoperative years 1 to 2 and 2 to 3 compared to matched nonsurgical controls.
Higher odds of acute lower RTI-related visits were observed in all 3 postoperative years among patients who underwent adenotonsillectomy.
Influenza- or pneumonia-related visits showed no statistically significant difference between the adenotonsillectomy group and controls.
Age-stratified analyses indicated higher odds of lower RTI-related visits among younger patients in specific postoperative years.

Diagnoses were based on administrative codes rather than direct clinical assessment.
Primary indication for adenotonsillectomy was not consistently available.
Lack of data on symptom severity, laboratory findings, and environmental factors.
Potential surveillance bias affecting RTI diagnosis and coding.
Infections not resulting in hospital visits may not have been captured.
Study could not address outcomes beyond the 3-year observation period.