Childhood Surgeries Now, Worry Later

Appendix, tonsils removal linked to greater heart attack risk in young people

(RxWiki News) Promises of eating ice cream for days usually does little to allay children's fears about getting their tonsils removed. The removal of an appendix is an even scarier proposition. But there may be some reason for that childhood apprehension.

A new study indicates that the removal of the tonsils or the appendix before the age of 20 is linked to an increased risk of heart attack.

"Wait to have your tonsillectomy or appendectomy."

The Swedish study, recently published in the European Heart Journal, revealed that a tonsillectomy increased the risk by 44 percent while an appendectomy increased the risk by 33 percent. Risk was significantly higher when both were removed, but no risk associated with removal beyond the age of 20.

Both the appendix and tonsils are lymphoid organs, which are components of the body's immune system and generally only removed after repeated infections or the rupture of the appendix. Between 10 and 20 percent of children and teens have one or both organs removed.

The study, which examined 54,449 appendectomies and 27,284 tonsillectomies, only looked at records for those under the age of 20 because the organs appear to have reduced function after adolescence. Of those, about 600 cases of heart attacks were examined in individuals who had their appendix or tonsils removed, or both.

Researchers studied the national health records of every Swedish resident born between 1955 and 1970 to identify those who had their tonsils or appendix removed. Each of those individual cases were then matched up with five randomly picked control cases who did not have an operation. The individuals were then followed for just over 23 years and monitored for heart attacks -- regardless of type or whether it was fatal.

Research investigator Dr. Imre Janszky from the Department of Public Health Science of the Karolinska Institute in Stockholm said the results were not surprising since other studies have indicated removal of the spleen, a secondary lymphoid organ like the tonsils and appendix, also has been associated with increased cardiovascular risk.

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Review Date: 
June 1, 2011