Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Laryngoscope. 2023 Aug;133(8):1846-1852. doi: 10.1002/lary.30367. Epub 2022 Aug 27.
This study aimed to investigate the risk factors associated with peritonsillar abscess (PTA) recurrence in adult patients.
This retrospective cohort study used a nationwide insurance claims database in Japan. Adult patients (aged ≥ 20 years) who received intravenous antibiotics or surgical therapy within 5 days of their first PTA diagnosis were included. Multivariable Cox proportional modeling was used to investigate the risk factors for PTA recurrence using the variables: age, sex, comorbidities, tobacco use, history of recurrent tonsillitis, duration of intravenous antibiotics, and surgical therapy for PTA.
This study included 12,012 patients (8784 men, 73.1%). Of them, 1358 (11.3%) experienced PTA recurrence. An age ≥40 years and treatment with intravenous antibiotics for 3 days or more were associated with a lower risk of PTA recurrence (aged ≥ 40 years: adjusted hazard ratio [HR]: 0.69; 95% confidence interval [CI]: 0.62-0.78, treated with intravenous antibiotics for 3 days or more: adjusted HR: 0.85; 95% CI: 0.76-0.96). Patients with a history of recurrent tonsillitis were associated with a higher risk of recurrence (adjusted HR: 1.79; 95% CI: 1.47-2.19).
A median age of 20-39 years, a history of recurrent tonsillitis, and less than 3 days of intravenous antibiotic therapy may be risk factors for PTA recurrence among adult patients. Further studies exploring more detailed clinical data are necessary to confirm the risk factors for PTA recurrence.
3 Laryngoscope, 133:1846-1852, 2023.
本研究旨在探讨与成人患者扁桃体周脓肿（PTA）复发相关的危险因素。
本回顾性队列研究使用了日本全国性的保险索赔数据库。纳入在首次 PTA 诊断后 5 天内接受静脉抗生素或手术治疗的成年患者（年龄≥20 岁）。使用多变量 Cox 比例风险模型，根据以下变量：年龄、性别、合并症、吸烟、复发性扁桃体炎史、静脉抗生素使用时间和 PTA 手术治疗，探讨 PTA 复发的危险因素。
本研究共纳入 12012 名患者（8784 名男性，73.1%）。其中 1358 名（11.3%）发生 PTA 复发。年龄≥40 岁和静脉抗生素治疗 3 天或以上与 PTA 复发风险降低相关（年龄≥40 岁：调整后的危险比[HR]：0.69；95%置信区间[CI]：0.62-0.78，静脉抗生素治疗 3 天或以上：调整后的 HR：0.85；95% CI：0.76-0.96）。复发性扁桃体炎史与复发风险升高相关（调整后的 HR：1.79；95% CI：1.47-2.19）。
20-39 岁的中位年龄、复发性扁桃体炎史和静脉抗生素治疗时间少于 3 天可能是成年患者 PTA 复发的危险因素。需要进一步研究以探索更详细的临床数据，以确认 PTA 复发的危险因素。
3 级。喉镜，133：1846-1852，2023 年。
