Diurnal variation of post-tonsillectomy haemorrhage

Area of Science:

• Otolaryngology
• Surgical Complications
• Public Health

Background:

• Post-tonsillectomy haemorrhage (PTH) is a common complication, often self-limiting but sometimes requiring intervention.
• PTH is categorized as primary (within 24 hours) or secondary (after 24 hours), with secondary PTH frequently occurring outside standard office hours.
• The exact etiology of secondary PTH, often associated with eschar sloughing, remains incompletely understood.

Purpose of the Study:

• To investigate diurnal variations in post-tonsillectomy haemorrhage (PTH) occurrences within a Danish patient cohort.
• To identify patterns in the timing of PTH events to inform healthcare resource allocation and patient safety protocols.

Main Methods:

• A retrospective cohort study analyzed data from ear-nose-throat (ENT) departments in Southern Denmark (2017-2021).
• Patients with International Classification of Diseases, tenth version (ICD-10) codes for tonsillectomy and post-operative haemorrhage were included.
• Hospital arrival times were categorized into three-hour slots to assess diurnal variation, with a chi-squared test used for data evaluation.

Main Results:

• Analysis included 459 contacts, with a PTH contact rate of 8% (382 events of active PTH, 6.7%).
• Focusing on secondary PTH (n=375), a significant diurnal fluctuation was observed.
• Nocturnal events (9 PM - 9 AM) constituted 62% (233 contacts) of secondary PTH hospital visits.

Conclusions:

• Post-tonsillectomy haemorrhage (PTH) contacts show a distinct pattern of increased frequency during nighttime hours.
• Healthcare providers should maintain vigilance during off-hours to optimize resource management and enhance patient safety.
• Further research into the underlying causes of PTH is warranted to improve preventative strategies and patient outcomes.