Paediatric Posttonsillectomy Haemorrhage Rates in Auckland: A Retrospective Case Series.

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Surgical Complications

Background:

• Tonsillectomy is a common pediatric surgical procedure for sleep-disordered breathing and infections.
• Post-tonsillectomy hemorrhage (PTH) is a significant complication despite surgical advancements.
• Regular auditing of PTH is crucial for monitoring surgical outcomes.

Purpose of the Study:

• To audit the incidence and characteristics of post-tonsillectomy hemorrhage (PTH) in pediatric patients.
• To identify risk factors associated with PTH in children undergoing tonsillectomy.
• To compare institutional outcomes with established literature benchmarks.

Main Methods:

• Retrospective case series of pediatric tonsillectomies (<15 years) in Auckland during 2017.
• Extraction and analysis of demographic, clinical, and surgical data.
• Univariate analysis to compare patients with and without PTH.

Main Results:

• Overall PTH rate was 3.6% (0.23% primary, 3.4% secondary), with a mean onset of 6.6 days.
• 28% of PTH cases required return to theatre (1% of all tonsillectomies); no deaths or major complications occurred.
• Children with PTH had smaller tonsils (p=0.004) and were less likely to have otitis media with effusion (p<0.001).

Conclusions:

• Reporting institutional tonsillectomy outcomes and complications is essential.
• The PTH rates observed in Auckland are within acceptable limits based on current literature.
• Smaller tonsil size and absence of otitis media with effusion may be associated with PTH risk.