Post-tonsillectomy haemorrhage more common than previously described – an institutional chart review

Abstract

Conclusions: Risk of post-tonsillectomy haemorrhage (PTH) was higher compared with previous studies and may be associated with the criteria used. Male gender and the use of haemostatic agents in the primary operation were associated with increased risk of PTH, whereas the use of non-steroidal anti-inflammatory drugs (NSAIDs) or dexamethasone was not. Objectives: The aim of the study was to investigate the risk of PTH in adult patients, and its association with the use of NSAIDs, dexamethasone, paracetamol, serotonin (5-HT3) receptor antagonists, haemostatic agents, age and gender during preceding tonsillectomy (TE). Methods: All PTH complications that resulted in an adult TE patient re-contacting the hospital were retrospectively recorded during a 12-month period. PTH types were allocated into three categories: (I) a history of bleeding, (II) bleeding requiring direct pressure or electrocautery under local anaesthesia or (III) reoperation under general anaesthesia. Results: A total of 842 adult TE patients (aged between 16 and 85.8 years) were included in the study. Of these, 122 patients experienced PTH (risk 14.5%). Risk of category III PTH was 1.5%. Risk factors for PTH were the use of haemostatic agents (p = 0.006) and male gender (p = 0.011). The use of NSAID, opioid, 5-HT3 receptor antagonist and dexamethasone medication did not significantly alter the number of postoperative bleeding events.