Incidence and potential risk factors of post-tonsillectomy hemorrhage

ABSTRACT

To evaluate the incidence of postoperative tonsillectomy hemorrhage [PTH] and to identify the possible risk factors associated with its occurrence. A Retrospective Study. Two private hospitals Mahayel Hospital and Saudi German Hospital. Four hundred seventy-seven patients had tonsillectomy or adenotonsillectomy from January 2008 to December 2013. All PTH incidents were identified. A data collection sheet was constructed by the author, which included patient's age, sex, and day of postoperative bleeding evaluation. Result: Two hundred eighty-eight [60.4%] were children and 189 [39.6%] were adults. Two hundred forty-two [50.7%] were males. The indication for tonsillectomy in 394 [82.6%] was recurrent tonsillitis and in 83 [17.4%] was obstructive sleep apnea. Twenty-nine [6.1%] patients had PTH, 8 [27.6%] had primary PTH and 21 [72.4%] had secondary. The incidence of PTH was significantly higher among adult patients than children [9%, 4.2%, respectively, p=0.031] and among patients with recurrent tonsillitis than those with obstructive sleep apnea [7.1%, 1.2%, respectively, p=0.041]. There were no statistically significant differences in timing of PTH [primary or secondary] according to patients' characteristics. The incidence of PTH in our study is not high. Risk factors include older age and preoperative recurrent tonsillitis. PTH occurs mainly 24 hours postoperatively. Awareness of these risk factors should help improve patient care and outcomes: