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Is weekend surgery a risk factor for post-tonsillectomy haemorrhage?

Published online by Cambridge University Press:  13 June 2016

A Patel*
Affiliation:
ENT Department, University Hospital Lewisham, UK
N Foden
Affiliation:
ENT Department, University Hospital Lewisham, UK
A Rachmanidou
Affiliation:
ENT Department, University Hospital Lewisham, UK
*
Address for correspondence: Mr A Patel, 9 Elstree Hill, Bromley BR1 4JE, UK Fax: 020 8333 333 E-mail: [email protected]

Abstract

Background:

Tonsillectomy is a common, low-risk procedure. Post-tonsillectomy haemorrhage remains the most serious complication. Recent nationwide studies in the UK have identified an increased morbidity and mortality for both high-risk and low-risk elective general surgery performed at the weekend.

Methods:

Data for tonsillectomies performed at a district general hospital over a three-year period were retrospectively reviewed. The same group of surgeons performed elective tonsillectomies on both weekends and weekdays. All patients who developed a post-tonsillectomy haemorrhage were identified and the day of original operation was noted.

Results:

Between 2010 and 2013, 2208 (94.00 per cent) elective tonsillectomies were performed on a weekday and 141 (6.00 per cent) were performed on the weekend. Post-tonsillectomy haemorrhages occurred in 104 patients (4.71 per cent) who underwent their procedure on a weekday and in 10 patients (7.09 per cent) who had their surgery at the weekend (p = 0.20).

Conclusion:

There is no difference in the rate of post-tonsillectomy haemorrhage for procedures performed on a weekday or weekend.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented at the 16th Association of Southeast Asian Nations (‘ASEAN’) Otolaryngology – Head Neck Surgery Congress, 11–13 November 2015, Chiang Mai, Thailand, and at the Society of Academic and Research Surgery, 6–7 January 2016, London, UK.

References

1 Brown, P, Ryan, R, Yung, M, Browne, J, Copley, L, Cromwell, D et al. National Prospective Tonsillectomy Audit. London: Royal College of Surgeons of England, 2005 Google Scholar
2 Stuck, B, Gotte, K, Windfuhr, FJ, Genzwurker, H, Schroten, H, Tenenbaum, T. Tonsillectomy in children. Dtsch Arztebl Int 2008;105:852–61Google Scholar
3 Konieczny, K, Biggs, T, Caldera, S. Application of the Paediatric Throat Disorders Outcome Test (T-14) for tonsillectomy and adenotonsillectomy. Ann R Coll Surg Engl 2013;95:410–14Google Scholar
4 Ostvoll, E, Sunnergren, O, Ericsson, E, Hemlin, C, Hultcrantz, E, Odhagen, E et al. Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden. Eur Arch Otorhinolaryngol 2015;272:737–43Google Scholar
5 Windfuhr, JP, Verspohl, BC, Chen, YS, Dahm, JD, Werner, JA. Post-tonsillectomy haemorrhage–some facts will never change. Eur Arch Otorhinolaryngol 2015;272:1211–18CrossRefGoogle ScholarPubMed
6 Burton, MJ, Doree, C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 2007;(3):CD004619 Google Scholar
7 Mosges, R, Hellmich, M, Allekotte, S, Albrecht, K, Bohm, M. Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials. Eur Arch Otorhinolaryngol 2011;268:807–16Google Scholar
8 Koscielny, J, Ziemer, S, Radtke, H, Schmutzler, M, Pruss, A, Sinha, P et al. A practical concept for preoperative identification of patients with impaired primary haemostasis. Clin Appl Thromb Hemost 2004;10:195204 Google Scholar
9 Aylin, P, Yunus, A, Bottle, A, Majeed, A, Bell, D. Weekend mortality for emergency admissions. A large, multicentre study. Qual Saf Health Care 2010;19:213–17Google Scholar
10 Aylin, P, Alexandrescu, R, Jen, MH, Mayer, EK, Bottle, A. Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics. BMJ 2013;346:f2424 Google Scholar
11 Mohammed, MA, Sidhu, KS, Rudge, G, Stevens, AJ. Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: a retrospective database study of National Health Service hospitals in England. BMC Health Serv Res 2012;12:87 Google Scholar
12 Becker, DJ. Do hospitals provide lower quality care on weekends? Health Serv Res 2007;42:1589–612Google Scholar
13 Fonarow, GC, Abraham, WT, Albert, NM, Stough, WG, Gheorghiade, M, Greenberg, BH et al. Day of admission and clinical outcomes for patients hospitalized for heart failure: findings from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF). Circ Heart Fail 2008;1:50–7Google Scholar
14 Roberts, S, Thorne, K, Akbari, A, Samuel, DJ, Williams, JG. Weekend emergency admissions and mortality in England and Wales. Lancet 2015;385:1829 CrossRefGoogle ScholarPubMed
15 Audit Commission. Operating Theatres – Review of National Findings. London: Audit Commission, 2003 Google Scholar