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Are More Adults Bleeding After Tonsillectomy Than in the Past?
Deepthi Akella1, Chloe Cottone2, Maya Raghavan2,3
1School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, Texas, USA.
The Laryngoscope
|January 28, 2025
Summary
Post-tonsillectomy hemorrhage (PTH) rates increased in adults over 15 years. This rise coincided with significant shifts in post-tonsillectomy pain management, warranting further investigation into the connection.
Area of Science:
- Otolaryngology
- Surgical Outcomes
- Public Health
Background:
- Post-tonsillectomy hemorrhage (PTH) incidence has risen in pediatric populations.
- The trend of PTH in adult populations remains less understood.
Purpose of the Study:
- To investigate the incidence of PTH in adults over a 15-year period.
- To analyze trends in analgesic use following tonsillectomy in adults.
Main Methods:
- Retrospective analysis of the TriNetX database (2008-2022).
- Inclusion of 72,232 adult patients who underwent tonsillectomy.
- Statistical analysis using the Mann-Kendall test for trend detection.
Main Results:
- PTH incidence increased from 4.1% in 2008 to 6.2% in 2022.
- The need for return to the operating room (RTOR) for PTH control rose from 0.7% to 2.4%.
- Significant shifts in analgesic prescribing patterns were observed, with decreased codeine use and increased use of NSAIDs and other opioids.
Conclusions:
- Adult post-tonsillectomy analgesia practices have evolved significantly.
- A concurrent increase in PTH incidence suggests a potential link requiring further research.
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