A telephone audit in parallel with the UK national tonsillectomy audit to investigate re-admission as a measure of secondary haemorrhage rate

Abstract

Objectives An audit to run in parallel with the remaining 5 months (at the time of conception) of the national tonsillectomy audit to examine the accuracy of re-admission following bleeding as a measure of secondary haemorrhage rate. Methods A retrospective, case series audit of all patients undergoing tonsillectomy between 29th April and 1st October 2004 at Frimley Park Hospital a UK District General Hospital. One hundred and twenty-nine patients (adults and children) undergoing tonsillectomy were contacted by telephone 2 weeks after surgery. The main outcome measures were reported bleeding and re-admission. We reviewed all studies reported in the literature investigating secondary haemorrhage rate in the community. Results This study demonstrated 19% ( n = 24) of patients experienced bleeding post-operatively. Ten per cent ( n = 13) returned to hospital for advice and were admitted. The literature review shows the variability of the proportion of patients with bleeding that are re-admitted is 33.3 standard deviations. Conclusions There are widely different regional re-admission rates for post-tonsillectomy secondary haemorrhage. Re-admission is an unreliable measure of secondary haemorrhage. Change of practise based on conclusions drawn from re-admission rates are unsound.