Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T19:18:22.303Z Has data issue: false hasContentIssue false

No association between obesity and post-tonsillectomy haemorrhage

Published online by Cambridge University Press:  22 May 2014

H Riechelmann*
Affiliation:
Department of Otorhinolaryngology, Medical University Innsbruck, Austria
E C Blassnigg
Affiliation:
Department of Otorhinolaryngology, Medical University Innsbruck, Austria
C Profanter
Affiliation:
Department of Otorhinolaryngology, Medical University Innsbruck, Austria
K Greier
Affiliation:
College of Education Edith Stein, Stams, Austria
F Kral
Affiliation:
Department of Otorhinolaryngology, Medical University Innsbruck, Austria
B Bender
Affiliation:
Department of Otorhinolaryngology, Medical University Innsbruck, Austria
*
Address for correspondence: Dr H Riechelmann, Department of Otorhinolaryngology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria E-mail: [email protected]

Abstract

Background:

The prevalence of overweight and obesity is increasing worldwide. The impact of overweight on post-tonsillectomy haemorrhage rates in children and adults is unclear.

Methods:

Body mass index and post-tonsillectomy haemorrhage were evaluated in all patients treated with tonsillectomy within one year in a tertiary referral centre. Bleeding episodes were categorised according to the Austrian Tonsil Study.

Results:

Between June 2011 and June 2012, 300 adults and children underwent tonsillectomy. Post-tonsillectomy haemorrhage occurred in 55 patients. Of those, 29 were type A (history of blood in saliva only, no active bleeding), 15 were type B (active bleeding, treatment under local anaesthesia) and 11 were type C (active bleeding, treatment under general anaesthesia). The return to operating theatre rate was 3.7 per cent. Post-tonsillectomy haemorrhage was more frequent in adolescents and adults than in children. Overweight or obesity was positively correlated with age. Post-tonsillectomy bleeding was recorded in 11.1 per cent of underweight patients, 18.9 per cent of normal weight patients and 18.7 per cent of overweight patients (p = 0.7). Data stratification (according to age and weight) did not alter the post-tonsillectomy bleeding risk (p = 0.8).

Conclusion:

Overweight or obesity did not increase the risk of post-tonsillectomy haemorrhage in either children or adults.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Elmadfa, I, Hasenegger, V, Wagner, K, Putz, P, Weidl, NM, Wottawa, D et al. Austrian Nutrition Report 2012. Vienna: Vienna Institute for Nutritional Sciences, 2012Google Scholar
2Greier, K, Riechelmann, H. Effects of migration background on weight status and motor performance of preschool children. Wien Klin Wochenschr 2014;126:95100Google Scholar
3Todd, DW. Anesthetic considerations for the obese and morbidly obese oral and maxillofacial surgery patient. J Oral Maxillofac Surg 2005;63:1348–53Google Scholar
4Mortensen, A, Lenz, K, Abildstrom, H, Lauritsen, TL. Anesthetizing the obese child. Paediatr Anaesth 2011;21:623–9Google Scholar
5Doyle, SL, Lysaght, J, Reynolds, JV. Obesity and post-operative complications in patients undergoing non-bariatric surgery. Obes Rev 2010;11:875–86CrossRefGoogle ScholarPubMed
6Donohoe, CL, Feeney, C, Carey, MF, Reynolds, JV. Perioperative evaluation of the obese patient. J Clin Anesth 2011;23:575–86CrossRefGoogle ScholarPubMed
7Roupakias, S, Mitsakou, P. Surgical morbidity in obese children. Asian J Surg 2012;35:99103Google Scholar
8Waisath, TC, Marciani, RD, Waisath, FD, James, L. Body mass index and the risk of postoperative complications with dentoalveolar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:169–73CrossRefGoogle ScholarPubMed
9Nafiu, OO, Reynolds, PI, Bamgbade, OA, Tremper, KK, Welch, K, Kasa-Vubu, JZ. Childhood body mass index and perioperative complications. Paediatr Anaesth 2007;17:426–30CrossRefGoogle ScholarPubMed
10Baugh, RF, Archer, SM, Mitchell, RB, Rosenfeld, RM, Amin, R, Burns, JJ et al. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg 2011;144(1 suppl):S130CrossRefGoogle ScholarPubMed
11Windfuhr, JP, Chen, YS, Remmert, S. Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 2005;132:281–6Google Scholar
12Ye, J, Liu, H, Zhang, G, Huang, Z, Huang, P, Li, Y. Postoperative respiratory complications of adenotonsillectomy for obstructive sleep apnea syndrome in older children: prevalence, risk factors, and impact on clinical outcome. J Otolaryngol Head Neck Surg 2009;38:4958Google ScholarPubMed
13Fung, E, Cave, D, Witmans, M, Gan, K, El Hakim, H. Postoperative respiratory complications and recovery in obese children following adenotonsillectomy for sleep-disordered breathing: a case-control study. Otolaryngol Head Neck Surg 2010;142:898905CrossRefGoogle ScholarPubMed
14Nafiu, OO, Green, GE, Walton, S, Morris, M, Reddy, S, Tremper, KK. Obesity and risk of peri-operative complications in children presenting for adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2009;73:8995CrossRefGoogle ScholarPubMed
15Gleich, SJ, Olson, MD, Sprung, J, Weingarten, TN, Schroeder, DR, Warner, DO et al. Perioperative outcomes of severely obese children undergoing tonsillectomy. Paediatr Anaesth 2012;22:1171–8Google Scholar
16Sarny, S, Ossimitz, G, Habermann, W, Stammberger, H. The Austrian Tonsil Study 2010 - part 1: statistical overview [in German]. Laryngorhinootologie 2012;91:1621Google ScholarPubMed
17Kromeyer-Hauschild, K, Wabitsch, M, Kunze, D, Geller, F, Geiß, HC, Hesse, V et al. Percentiles of body mass index in children and adolescents evaluated from different regional German studies [in German]. Monatsschr Kinderheilkd 2001;149:807–18CrossRefGoogle Scholar
18Sarny, S, Habermann, W, Ossimitz, G, Stammberger, H. The Austrian Tonsil Study 2010 - part 2: postoperative haemorrhage [in German]. Laryngorhinootologie 2012;91:98102Google ScholarPubMed
19Lowe, D, van der Meulen, J, Cromwell, D, Lewsey, J, Copley, L, Browne, J et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117:717–24Google Scholar
20Sarny, S, Habermann, W, Ossimitz, G, Schmid, C, Stammberger, H. Tonsilar haemorrhage and re-admission: a questionnaire based study. Eur Arch Otorhinolaryngol 2011;268:1803–7Google Scholar
21Sarny, S, Ossimitz, G, Habermann, W, Stammberger, H. Austrian tonsil study part 3: surgical technique and postoperative haemorrhage after tonsillectomy [in German]. Laryngorhinootologie 2012;92:92–6Google ScholarPubMed