Main Theme: General
Introduction:
Seasonal changes in infection burden, environmental conditions and healthcare utilisation may influence recovery after paediatric tonsillectomy. This study examined whether postoperative outcomes following paediatric tonsillectomy in England varied by season.
Methods:
A retrospective observational study was performed using national aggregate data derived from Hospital Episode Statistics and Office for National Statistics data. Paediatric tonsillectomies between 1 April 2012 and 31 March 2025 were included. Outcomes were length of stay (LOS) ≥2 nights, all-cause 30-day emergency readmission, readmission with bleeding, surgical arrest of post-tonsillectomy bleeding (PTB), readmission with infection, and readmission with pain. Pairwise seasonal comparisons were performed using Pearson chi-squared tests with Holm correction for multiple testing.
Results:
A total of 349,993 paediatric tonsillectomies were analysed. Overall, 3.21% had LOS ≥2 nights , 6.73% had 30-day emergency readmission, 4.42% had readmission with PTB, 0.78% underwent surgical arrest of PTB, 0.67% had readmission with infection, 0.70% had readmission with pain. LOS ≥2 nights was significantly higher in Winter Vs. Summer (RR 1.081), Winter Vs. Autumn (RR 1.091), Spring Vs. Summer (RR 1.133) and Spring Vs Autumn (RR 1.143). LOS ≥2 nights differences we most prominent in the 0-2 & 3-4 age groups. Bleeding-related outcomes showed no robust overall seasonal variation.
Conclusion:
A clear, albeit modest seasonal effect was demonstrated on LOS ≥2 nights LOS ≥2 nights , particularly in younger children, whereas bleeding outcomes showed little consistent overall seasonal variation.