Predictive factors for quality of life after tonsillectomy among adults with recurrent pharyngitis: a prospective cohort study.

ABSTRACT

OBJECTIVES: To assess health-related quality of life (QoL) and clinical factors predicting it after tonsillectomy among adult patients with recurrent pharyngitis. DESIGN: Prospective cohort design. SETTING: Tertiary referral centre. PARTICIPANTS: Adults (n = 153) who underwent tonsillectomy for recurrent pharyngitis. MAIN OUTCOME MEASURES: QoL 6 months after tonsillectomy measured by the Glasgow Benefit Inventory (GBI). Factors predicting high postoperative QoL were sought using multiple linear regression analysis. RESULTS: Of the 142 patients (93% of all eligible) responding to the GBI questionnaire, 94 (66%) were female; median age was 26 years (range 14-65). GBI Total Scores varied markedly (range -19 to +69), but on average showed improvement (median +27, interquartile range 18-36), most evidently in the GBI Physical Health Score (median +83), after tonsillectomy. Among routinely recorded clinical characteristics, the number of prior pharyngitis episodes, frequent throat pain, untreated dental caries and chronically infected tonsils made up the optimal subset of factors for predicting the GBI Total Score. However, in a random sample of patients (n = 56) for whom preoperative diary-based data were also available, somewhat better predictive ability was achieved based on just two diary items number of days with throat pain and with fever during the preceding few months (correlation coefficient, r, between observed and fitted scores improved from 0.39 to 0.55). Yet, the precision of even these predictions was still quite low. CONCLUSIONS: Adult patients with recurrent pharyngitis were on average satisfied after tonsillectomy, regardless of the aetiology of the episodes. Clinical factors rather modestly predicted which patients benefited most from the operation.