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Risk factors for post-tonsillectomy hemorrhage.

Ryo Ikoma1, Sayaka Sakane1, Kazutomo Niwa1

  • 1Department of Otolaryngology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura-higashi, Kanazawa-ku, Yokohama 236-0037, Japan.

Auris, Nasus, Larynx
|March 8, 2014
PubMed
Summary

Post-tonsillectomy hemorrhage (PTH) occurred in 11.6% of patients, with higher rates in adults and males. Adult age and male gender are key risk factors for PTH, while surgeon skill impacts severe hemorrhage requiring reoperation.

Keywords:
BleedingPostoperative hemorrhageReoperationTonsillectomy

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Area of Science:

  • Otolaryngology
  • Surgical Outcomes Research
  • Hemorrhagic Complication Analysis

Background:

  • Post-tonsillectomy hemorrhage (PTH) is a significant post-operative complication.
  • Understanding the incidence and risk factors for PTH is crucial for patient safety and effective management.

Purpose of the Study:

  • To determine the incidence of PTH at a single institution.
  • To identify and evaluate clinical risk factors associated with PTH, including severity.

Main Methods:

  • Retrospective review of 692 patients undergoing tonsillectomy (TE).
  • Classification of PTH severity into three grades based on treatment requirements.
  • Analysis of clinical factors including patient demographics, surgical details, and post-operative care.

Main Results:

  • Overall PTH incidence was 11.6% (1.6% primary, 10.0% secondary).
  • Reoperation for severe PTH (Category III) occurred in 2.6% of patients.
  • Adult age (OR=18.9) and male gender (OR=3.78) were significant risk factors for PTH.
  • Male gender, adult age, and surgeon skill level were risk factors for Category III PTH.

Conclusions:

  • The observed PTH rate was higher than in some previous studies, potentially due to differing definitions.
  • Adult age and male gender are confirmed clinical risk factors for post-tonsillectomy hemorrhage.
  • Surgeon's skill level is an additional identified risk factor for severe PTH requiring reoperation.