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Published on: November 6, 2019
Post-tonsillectomy Hemorrhage: A Seven-year Retrospective Study
Afsaneh Mohammadpour-Maleki1, Bashir Rasoulian1
1Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Post-tonsillectomy hemorrhage (PTH) requiring surgery is more likely in patients over 6 years old if bleeding occurs within the first week. Adults, bilateral tonsil bleeding, and blood transfusions predict the need for surgical intervention.
Area of Science:
- Otolaryngology
- Surgical Complications
- Hemorrhage Management
Background:
- Post-tonsillectomy hemorrhage (PTH) is a significant complication following tonsillectomy.
- Immediate surgical intervention may be necessary for severe bleeding.
- Understanding predictors of PTH severity is crucial for patient management.
Purpose of the Study:
- To investigate the association between patient age, timing of PTH onset, and the requirement for surgical intervention.
- To identify key factors influencing the need for surgery to control post-tonsillectomy bleeding.
Main Methods:
- Retrospective analysis of 227 patients with PTH admitted to two tertiary hospitals (2012-2019).
- Data collected included demographics, bleeding characteristics, and interventions.
- Statistical analyses included Chi-square, independent samples T-test, and binary logistic regression.
Main Results:
- A total of 227 patients with PTH were analyzed (mean age 14.99 years; 56.4% male).
- 63 patients (27.8%) required surgery; mean PTH onset was 8.14 days post-surgery.
- Patients aged 6+, experiencing PTH within the first week, were more likely to need surgery (P=0.034).
- Adults (OR=4.032), bilateral tonsil bleeding (OR=2.380), and blood transfusion (OR=7.934) were independent predictors for surgical treatment.
Conclusions:
- PTH occurring within the first postoperative week in patients over 6 years old warrants close monitoring.
- Adult patients, bilateral tonsil bleeding, and blood transfusion are significant indicators for potential surgical intervention.
- These factors can help predict the need for surgery in managing post-tonsillectomy hemorrhage.
Introduction:
Post-tonsillectomy hemorrhage (PTH) is a serious complication that sometimes requires immediate surgical interventions. The present study aimed to assess the association between patients' age, the time of onset of PTH, and the need for surgery to control bleeding.
Materials And Methods:
All patients with PTH were retrospectively admitted to two tertiary hospitals in Mashhad, during 2012-2019. Hospital records were investigated to select eligible cases and retrieve their characteristics such as demographics, source and time of bleeding, and type of intervention. Chi-square, independent samples T-test, and binary logistic regression were used as research tools.
Results:
A total of 227 patients with PTH and a mean age of 14.99±10.34 years were studied, of whom 128 (56.4%) were male and 63 (27.8%) required surgery to control PTH. The mean onset of PTH was 8.14±3.47 days after the surgery and in 59 cases (26.5%) was the seventh day. Those patients aged 6 years or older in whom PTH occurred during the first postoperative week were significantly more likely to need surgery to control it (P= 0.034). Adult (OR= 4.032, 95%CI= 1.932-8.414, P<0.001), bleeding from both tonsils (OR= 2.380, 95%CI= 1.032-5.487, P= 0.042), and receiving blood transfusion (OR= 7.934, 95%CI= 2.003-31.422, P= 0.002) were independent predictors of the need for surgical treatment to control PTH.
Conclusion:
PTH within the first postoperative week in patients older than 6 years, adults, bleeding from both tonsils, and receiving a blood transfusion is recommended to be considered as a potential predictor of the need for surgery.
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