Risk Factors For Post-Tonsillectomy Hemorrhage
Abstract
Objectives:
This research was undertaken to determine the frequency of post-tonsillectomy hemorrhage (PTH) in one particular clinical setting and to assess which risk factors exist for PTH.
Methods:
Following a retrospective case review of 892 patients who had gone through either tonsillectomy or adenotonsillectomy, a subgroup of 50 records were selected for detailed study. These 50 patients were then classified as either pediatric cases (aged under 16) or adult cases (aged over 16). Their risk factors were then assessed. Risk factors included: age, sex, surgical indication; type of surgery; time hospitalized post-operatively; timing of PTH (primary and secondary); management used to staunch bleeding and time in hospital following PTH.
Results:
The overall rate of PTH was 5.6% (3.0% pediatric, 2.6% adult). All PTH instances were secondary and no primary type occurred. In comparing the adult and pediatric cases of PTH, there was no statistically significant difference (p>0.05) in terms of age, sex, time hospitalized post-operatively, management used to staunch bleeding or time in hospital following PTH. There was, however, a statistically significant difference (p<0.05) between groups in terms of surgical indication and timing of PTH (primary or secondary).
Conclusion:
There was an increased frequency of secondary PTH in both groups. PTH typically happened between day 5 and 10 post-operatively. Patients need to be advised about this risk and show caution regarding factors that increase the risk of PTH after surgery.
Keywords
Kaynakça
- 1. Ikoma R, Sakane S, Niwa K, Kanetaka S, Kawano T, Oridate N. Risk factors for post-tonsillectomy hemorrhage. Auris Nasus Larynx 2014;41:376-9.
- 2. Nguyen TBV, Chin RY, Paramaesvaran S, Eslick GD. Routine tonsillar bed oversew after diathermy tonsillectomy: does it reduce secondary tonsillar hemorrhage? Eur Arch Otorhinolaryngol 2014;271:3005-10.
- 3. Walner DL, Karas A. Standardization of reporting post-tonsillectomy bleeding. Ann Otol Rhinol Laryngol 2013;122:277-82.
- 4. Sarny S, Habermann W, Ossimitz G, Schmid C, Stammberger H. Tonsillar hemorrhage and re- admission: a questionnaire based study. Eur Arch Otorhinolaryngol 2011;268:1803-7.
- 5. Sun GH, Harmych BM, Dickson JM, Gonzalez del Rey JA, Myer CM, Greinwald JH. Characteristics of children diagnosed as having coagulopathies following posttonsillectomy bleeding. Arch Otolaryngol Head Neck Surg 2011;137:65-8.
- 6. Ulualp SO. Rate of post-tonsillectomy hemorrhage after elective bipolar microcauterization of nonbleeding vessels. Eur Arch Otorhinolaryngol 2012;269:1269-75.
- 7. Kim DW, Koo JW, Ahn SH, Lee CH, Kim JW. Difference of delayed post-tonsillectomy bleeding between children and adults. Auris Nasus Larynx 2010;37:456-60.
- 8. Kaygusuz I, Susaman N. The effects of dexamethasone, bupivacaine and topical lidocaine spray on pain after tonsillectomy. Int J Pediatr Otorhinolaryngol 2003;67:737-42.
Ayrıntılar
Birincil Dil
İngilizce
Konular
Sağlık Kurumları Yönetimi
Bölüm
Araştırma Makalesi
Yazarlar
İrfan Kaygusuz
Bu kişi benim
Turgut Karlıdag
Bu kişi benim
Erol Keles
Bu kişi benim
Sinasi Yalcın
Bu kişi benim
Rabia Efe Cilibas
Bu kişi benim
Yayımlanma Tarihi
31 Ağustos 2018
Gönderilme Tarihi
29 Mayıs 2018
Kabul Tarihi
20 Haziran 2018
Yayımlandığı Sayı
Yıl 2018 Cilt: 8 Sayı: 2