Post-Tonsillectomy Bleeding: A National Perspective
- PMID: 33435723
- DOI: 10.1177/0003489420987438
Post-Tonsillectomy Bleeding: A National Perspective
Abstract
Objectives: Tonsillectomy is one of the most common otolaryngologic procedures. Hemorrhage after tonsillectomy is one of the most feared complications by surgeons and patients alike. The objective of this study was to analyze the risk factors associated with an increase in post-tonsillectomy hemorrhage in the pediatric population using a large national database.
Methods: The Kids' Inpatient Database (KID) from 2000 to 2012 was queried for patients between the ages of 1 to 17 years with post-tonsillectomy hemorrhage. Univariate and multivariate analyses were performed to obtain trends in patient demographics, comorbidities, and hospital information.
Results: Overall 45 940 pediatric cases of tonsillectomy were identified of which 5470 (11.9%) resulted in postoperative hemorrhage. Patients with postoperative hemorrhage were significantly older with mean age of 8.62 (±4.75) compared to all patients. Females were found to have higher rates of hemorrhage when compared to males 14.6% versus 11.5% (P < .001). The rate of white patients who had hemorrhage was 16.3% (P < .001). The most common comorbidities significantly associated with hemorrhage were fluid and electrolyte disorders (6.6% P < .001), deficiency anemia (3.8%; P < .001), and coagulopathy (2.7%; P < .001). Urban nonteaching hospitals had higher rates of hemorrhage (19.6%; P < .001) and the Northeast was the most common region (15.2%; P < .001). On multivariate analysis, older patients and white ethnicity showed a significantly increased risk of hemorrhage. Patients with pre-existing comorbidities such as coagulopathy, deficiency anemia, and fluid and electrolyte disorders circulation were also found to have higher odds ratios of bleeding.
Conclusion: Postoperative hemorrhage is a common complication following tonsillectomy with a rate of 11.9% in this study. A higher rate of hemorrhage was seen with increasing age, white race, and males overall, as well as patients with fluid and electrolyte disorders. Urban non-teaching hospitals and the Northeast region also saw increased rates of hemorrhage.
Keywords: bleeds; hemorrhage; pediatric; postoperative; tonsillectomy.
Similar articles
-
Posttonsillectomy hemorrhage in children with von Willebrand disease or hemophilia.JAMA Otolaryngol Head Neck Surg. 2013 Mar;139(3):245-9. doi: 10.1001/jamaoto.2013.1821. JAMA Otolaryngol Head Neck Surg. 2013. PMID: 23657425
-
Population-based survey of inpatient pediatric tonsillectomy and postoperative hemorrhage in Taiwan, 1997-2012.Int J Pediatr Otorhinolaryngol. 2018 May;108:55-62. doi: 10.1016/j.ijporl.2018.02.021. Epub 2018 Feb 15. Int J Pediatr Otorhinolaryngol. 2018. PMID: 29605366
-
Predictors of Complications of Tonsillectomy With or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010: A Population-Based Study.Clin Pediatr (Phila). 2016 Jun;55(7):593-602. doi: 10.1177/0009922815616885. Epub 2015 Nov 24. Clin Pediatr (Phila). 2016. PMID: 26603580
-
Dexamethasone and postoperative bleeding after tonsillectomy and adenotonsillectomy in children: A meta-analysis of prospective studies.Laryngoscope. 2012 May;122(5):1158-64. doi: 10.1002/lary.21881. Epub 2012 Mar 23. Laryngoscope. 2012. PMID: 22447657 Review.
-
Future of pediatric tonsillectomy and perioperative outcomes.Int J Pediatr Otorhinolaryngol. 2013 Feb;77(2):194-9. doi: 10.1016/j.ijporl.2012.10.016. Epub 2012 Nov 16. Int J Pediatr Otorhinolaryngol. 2013. PMID: 23159321 Review.
Cited by
-
The relationship between posttonsillectomy bleeding to hemogram and coagulation parameters.Eur Arch Otorhinolaryngol. 2024 May;281(5):2569-2574. doi: 10.1007/s00405-024-08487-2. Epub 2024 Feb 5. Eur Arch Otorhinolaryngol. 2024. PMID: 38315176
-
The Effect of Tranexamic Acid Local Injection on Bleeding during and after Tonsillectomy: A Double-Blind Randomized Placebo-Controlled Trial.World J Plast Surg. 2023;12(3):31-36. doi: 10.61186/wjps.12.3.31. World J Plast Surg. 2023. PMID: 38226192 Free PMC article.
-
Is it possible to predict post-adenotonsillectomy hemorrhage in children with preoperative blood tests? Single-center retrospective study.Sci Prog. 2023 Oct-Dec;106(4):368504231215591. doi: 10.1177/00368504231215591. Sci Prog. 2023. PMID: 38055322 Free PMC article.
-
Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial.Health Sci Rep. 2023 Nov 14;6(11):e1688. doi: 10.1002/hsr2.1688. eCollection 2023 Nov. Health Sci Rep. 2023. PMID: 38028678 Free PMC article.
-
Unveiling the Enigmatic Adenoids and Tonsils: Exploring Immunology, Physiology, Microbiome Dynamics, and the Transformative Power of Surgery.Microorganisms. 2023 Jun 21;11(7):1624. doi: 10.3390/microorganisms11071624. Microorganisms. 2023. PMID: 37512798 Free PMC article. Review.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical