title: Tonsillectomy, adenoidectomy and adenotonsillectomy rates in school-aged children: Relative contributions of socio-demographic and clinical features.
abstract: OBJECTIVE
  The present study sought to investigate the frequencies of tonsillectomy, adenoidectomy and both adenotonsillectomy (T&A) among 6-12 years old children. In addition, we tried to find out the predictors associated with these previous upper respiratory tract (URT) surgeries.
  
  
  METHODS
  This cross-sectional study consisted of 1900 children educated in 3 different elementary schools in Ankara, Turkey. Data about demographics and health conditions were obtained from survey questionnaires completed by parents.
  
  
  RESULTS
  Of the 1900 children, 15 children (0.8%) previously underwent tonsillectomy, 43 children (2.3%) had adenoidectomy and 80 children (4.2%) had T&A surgical histories. Multiple logistic regression analysis revealed that older students compared to younger ones [odds ratio (OR) = 1.15, p = 0.011], and those who had parent-reported apnea compared to subjects without apnea were more likely to have URT surgery histories [OR = 2.34, p = 0.001]. Those children with surgery histories were more likely to have fathers with a higher educational level [medium level: OR = 2.07, p = 0.012; high level: OR = 2.79, p = 0.001 vs. low level) and the subjects had greater BMI percentiles [overweight: OR = 1.71, p = 0.036; obesity: OR = 2.32, p = 0.003 vs. healthy weight]. Children who had 1-2 URT infections per year [OR = 0.47, p = 0.019] had less probability of URT surgery histories, whereas those children with AOM ≥ 3 times per year [OR = 2.52, p = 0.003] had more probability of URT surgery history.
  
  
  CONCLUSIONS
  We conclude that a reasonable explanation for higher rates of URT surgery among children with a high level of paternal education may originate from their awareness about URT associated diseases and possibly due to the ease of access to health care services.
authors.affiliation: Department of Family Medicine, Turkish Military Academy, Primary Care Examination Center, Ankara, Turkey; Department of Family Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: ycetindoganer@hotmail.com.
authors.forename: Yusuf C
authors.initials: YC
authors.lastname: Doganer
authors.affiliation: Department of Family Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
authors.affiliation: Department of Family Medicine, Gulhane Military Medical Faculty, Ankara, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Aydogan
authors.affiliation: Department of Family Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: McKennan J
authors.initials: MJ
authors.lastname: Thurston
authors.affiliation: Department of Internal Medicine, Gulhane Military Medical Faculty, Ankara, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Saglam
mesh_terms: D000233:Adenoidectomy / Q000706:statistics & numerical data*; D002648:Child; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D012141:Respiratory Tract Infections / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors; D014068:Tonsillectomy / Q000706:statistics & numerical data*; D014421:Turkey
keywords: Adenoidectomy; Adenotonsillectomy (T&A); Children; Tonsillectomy