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Temporal fluctuations of post-tonsillectomy haemorrhage
Stefan Grasl1, Patrick Mekhail1, Stefan Janik1
1Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
Summary
Post-tonsillectomy hemorrhage (PTH) occurs more frequently at night, with increased risk the longer after surgery. This finding is crucial for patient education and ensuring medical staff are prepared for nocturnal emergencies.
Area of Science:
- Otolaryngology
- Surgical Complications
- Circadian Rhythms
Background:
- Post-tonsillectomy hemorrhage (PTH) is a significant complication.
- Little is known about the timing of PTH onset.
- Understanding temporal patterns can improve patient care.
Purpose of the Study:
- To investigate circadian and seasonal rhythms of PTH.
- To identify potential ramifications for patient and staff education.
- To analyze temporal patterns of severe post-tonsillectomy bleeding.
Main Methods:
- Retrospective study of 300 patients requiring emergency surgery for severe PTH (1993-2019).
- Analysis of patient demographics, surgical details, and timing of hemorrhage.
- Statistical tests including Kruskal-Wallis, Mann-Whitney U, and Chi-square.
Main Results:
- Severe PTH requiring emergency surgery occurred predominantly during evening and night hours (64.7%).
- The risk of nocturnal PTH increased with the time elapsed since the initial surgery.
- No significant seasonal variations were observed; age, sex, and procedure details did not influence timing.
Conclusions:
- Temporal fluctuations in PTH, particularly nocturnal occurrences, are clinically significant.
- Findings necessitate enhanced patient awareness and preoperative education.
- Management of severe PTH requires dedicated resources and on-call trained medical staff.
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