Observational studyClinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery2026
Tonsillectomy Complications in Adults: A Retrospective Observational Cohort Study of National Health Service Patients in England Using Hospital Episode Statistics.
Observational study in Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo characterise adult tonsillectomy procedures conducted in the NHS from routine administrative data in England and investigate trends in their associated complications over time.
designRetrospective observational cohort study using routine data from Hospital Episode Statistics (HES).
settingAcute NHS trusts in England are conducting adult tonsillectomy.
participantsAdults (> 16 years old) undergoing tonsillectomy procedure with a primary diagnosis of any non-malignant indication, and with no current or historic cancer, or benign neoplasm.
main outcome measuresNumber of procedures, in-hospital complications, readmissions within 28 days and trends over time.
resultsA total of 198 130 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-hospital complication, with a total of 1967 patients having a haemorrhage or surgical arrest of post-operative bleeding from the tonsillar bed or adenoid; occurring more frequently in men (1.7% versus 0.7%, p < 0.001). A total of 33 934 patients were readmitted as an emergency within 28 days of surgery, almost doubling between 2008/09 and 2022/23. Readmission with bleeding within 28 days 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.
conclusionsTonsillectomy 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.
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