Kim So Young, Min Chanyang, Oh Dong Jun, Choi Hyo Geun
Department of Otorhinolaryngology - Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam.
Hallym Data Science Laboratory, Hallym University College of Medicine.
Medicine (Baltimore). 2019 May;98(19):e15579. doi: 10.1097/MD.0000000000015579.
The purpose of this study was to evaluate the risk of appendectomy due to appendicitis after tonsillectomy in Koreans using national cohort data. Using the national cohort study from the Korean Health Insurance Review and Assessment Service, 1:4 matched tonsillectomy participants (9015) and control participants (36,060) were selected. The Cox-proportional hazard model was used. In this analysis, a crude and adjusted model for age, sex, income, region of residence, and the past medical histories of hypertension, diabetes mellitus, and dyslipidemia were used. For the subgroup analyses, the participants were divided as follows: children (≤14 years old) vs adolescents and adults (≥15 years old) and men vs women. The adjusted hazard ratio (HR) of tonsillectomy for appendectomy was 1.06 (95% confidence interval, CI = 0.89-1.27, P = .517). In the subgroup analysis, the HR was 1.03 (95% CI = 0.82-1.30, P = .804) in children and 1.10 (95% CI = 0.84-1.47, P = .468) in adolescents and adults. In another subgroup analysis, the HR was 0.89 (95% CI = 0.70-1.12, P = .314) in men and 1.39 (95% CI = 1.06-1.83, P = .018) in women. The risk of appendectomy was higher in the tonsillectomy group but only in women.
本研究旨在利用全国队列数据评估韩国人扁桃体切除术后因阑尾炎行阑尾切除术的风险。利用韩国健康保险审查与评估服务机构的全国队列研究，选取了1:4匹配的扁桃体切除参与者（9015名）和对照参与者（36060名）。采用Cox比例风险模型。在该分析中，使用了年龄、性别、收入、居住地区以及高血压、糖尿病和血脂异常既往病史的粗模型和调整模型。对于亚组分析，参与者按以下方式分组：儿童（≤14岁）与青少年及成人（≥15岁）以及男性与女性。扁桃体切除术与阑尾切除术的调整后风险比（HR）为1.06（95%置信区间，CI = 0.89 - 1.27，P = 0.517）。在亚组分析中，儿童的HR为1.03（95%CI = 0.82 - 1.30，P = 0.804），青少年及成人的HR为1.10（95%CI = 0.84 - 1.47，P = 0.468）。在另一亚组分析中，男性的HR为0.89（95%CI = 0.70 - 1.12，P = 0.314），女性的HR为1.39（95%CI = 1.06 - 1.83，P = 0.018）。扁桃体切除组阑尾切除术风险更高，但仅在女性中如此。
