Evaluation and Risk Factor Analysis of Post-tonsillectomy Hemorrhage in an Adult Population: An Experience From a National Ear, Nose, and Throat (ENT) Center in Georgia.

Abstract

Tonsillectomy, a common surgical procedure for removing the palatine tonsils, is frequently performed in the otorhinolaryngology department. Tonsillectomy, with or without adenoidectomy, is considered a straightforward operation. However, serious complications, such as post-tonsillectomy hemorrhage, can complicate the recovery period. The research aims to analyze and estimate the factors associated with postoperative bleeding in the adult Georgian population. We conducted a cross-sectional study. The data was collected retrospectively from the medical records of adult patients aged 18 years and older, who underwent tonsillectomy in 2022 and 2023 at the National Center of Otorhinolaryngology,Japaridze-Kevanishvili Clinic, in Georgia. We performed univariate analysis using binary logistic regression and multivariate logistic regression analysis and calculated odds ratio (OR) to identify factors associated with postoperative bleeding among patients with tonsillectomy. A p-value of <0.05 was considered statistically significant. A total of 778 adult patients with tonsillectomy were included in the study. Post-tonsillectomy hemorrhage occurred in 14.7% (n=114) of cases, with primary bleeding observed in 8.1% (n=63) of patients and secondary bleeding in 6.6% (n=51) of cases. The highest incidence of bleeding was observed on days 1 (8.1%, n=63) and 7 (1.3%, n=10). The statistical analysis revealed a statistically significant association between post-tonsillectomy hemorrhage and several factors: smoking status (OR=10.1, 95% CI: 6.1-16.7, p<0.001) and having a body mass index (BMI) greater than 25 (OR=3.6, 95% CI: 2.1-6.1, p<0.001). The study confirmed several significant risk factors, including smoking and higher BMI, that are associated with an increased risk of bleeding among patients, undergoing tonsillectomy. Further research is needed to validate these findings in the Georgian population.