264 The Impact of COVID-19 on Elective Tonsillectomies in Greater Glasgow and Clyde

Aim Recurrent tonsillitis causes increased morbidity, and negatively impacts a patient’s quality of life. COVID-19 led to a dramatic decline in elective tonsillectomies. Our aim is to quantify the impact of COVID-19 on the number of elective tonsillectomies performed in the adult and paediatric populations; evaluate the impact of the pandemic on healthcare outcomes and utilisation, including indication for surgery, SIGN compliance, waiting times, post-operative complications. Method This study employed a multicentre retrospective population analysis within the NHS Greater Glasgow and Clyde (GGC) health board, looking at adult and paediatric populations (n=2,535 and n=4,166 respectively) from 2016 to June 2023. A further retrospective cohort analysis compared the adult cohorts of 2016 (n=359) and 2021 (n=89). Results Adult and paediatric tonsillectomies declined from 2016 to 2021 by 81.0% (p<0.0001) and 33.1% (p<0.01) respectively. Detailed analysis revealed an increased proportion of adult tonsillectomies with diagnostic purposes (11% to 31%), as opposed to recurrent tonsillitis which fell (74% to 52%). In 2016, 66.98% of routine adult tonsillectomies complied with the Scottish Government (12 weeks), whereas in 2021 only 4.92% met this target. Conversely, post-operative bleeding decreased from 1 in 4 (24.5%) to 1 in 5 (20.2%) over this timeline. Conclusions Considering COVID-19, surgical prioritisation led to a fall in elective tonsillectomies. The numbers have recovered to pre-pandemic levels in children, reflecting the greater urgency to reduce the risk of long-term cardiovascular health problems associated with obstructive sleep apnoea. Furthermore, this study demonstrates the marked changes to routine tonsillectomy practice in the GGC health board because of COVID-19.