Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T23:03:47.488Z Has data issue: false hasContentIssue false
  • English
  • Français

Risk factors for secondary post-tonsillectomy haemorrhage following tonsillectomy with bipolar scissors: four-year retrospective cohort study

Published online by Cambridge University Press:  29 December 2016

T Harju  and
J Numminen
T Harju*
Affiliation:
Department of Otorhinolaryngology, Tampere University Hospital, Finland
J Numminen
Affiliation:
Department of Otorhinolaryngology, Tampere University Hospital, Finland
*
Address for correspondence: Dr Teemu Harju, Department of Otorhinolaryngology, Tampere University Hospital, Teiskontie 35, 33521 Tampere, Finland E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To analyse risk factors associated with secondary post-operative bleeding when only one technique, namely bipolar scissors, is used.

Methods:

The medical records of all consecutive patients aged six years or older who underwent tonsillectomy or adenotonsillectomy between 1 December 2010 and 30 November 2014 were retrospectively analysed.

Results:

A total of 1734 patients were included in the study. A secondary haemorrhage occurred in 208 patients (12 per cent). Patients aged 15 years or older were 4.5 times (95 per cent confidence interval = 2.6–7.9; p < 0.001) more likely to experience secondary haemorrhage. In cases of acute quinsy, patients aged 15 years or older had an 8.1-fold (95 per cent confidence interval = 1.1–59.6; p = 0.02) increased likelihood of experiencing secondary haemorrhage.

Conclusion:

Patients aged 15 years or older have a higher risk for bleeding regardless of the primary indication for the tonsillectomy. The risk for secondary haemorrhage does not seem to depend on the primary indication itself.

Keywords

TonsillectomyHemorrhageRisk FactorsAge GroupsSex
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 2 , February 2017 , pp. 155 - 161
Copyright
Copyright © JLO (1984) Limited 2016 

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

1 Windfuhr, JP. Serious complications following tonsillectomy: how frequent are they really? ORL J Otorhinolaryngol Relat Spec 2013;75:166–73Google Scholar
2 Mowatt, G, Cook, JA, Fraser, C, McKerrow, WS, Burr, JM. Systematic review of the safety of electrosurgery for tonsillectomy. Clin Otolaryngol 2006;31:95–102 Google Scholar
3 Attner, P, Haraldsson, PO, Hemlin, C, Hessén Soderman, AC. A 4-year consecutive study of post-tonsillectomy haemorrhage. ORL J Otorhinolaryngol Relat Spec 2009;71:273–8CrossRefGoogle ScholarPubMed
4 Ahsan, F, Rashid, H, Eng, C, Bennett, DM, Ah-See, KW. Is secondary haemorrhage after tonsillectomy in adults an infective condition? Objective measures of infection in a prospective cohort. Clin Otolaryngol 2007;32:24–7Google Scholar
5 Stephens, JC, Georgalas, C, Kyi, M, Ghufoor, K. Is bacterial colonisation of the tonsillar fossa a factor in post-tonsillectomy haemorrhage? J Laryngol Otol 2008;122:383–7Google Scholar
6 Liu, JH, Anderson, KE, Willging, JP, Myer, CM 3rd, Shott, SR, Bratcher, GO et al. Posttonsillectomy hemorrhage: what is it and what should be recorded? Arch Otolaryngol Head Neck Surg 2001;127:1271–5Google Scholar
7 Lowe, D, van der Meulen, J; National Prospective Tonsillectomy Audit. Tonsillectomy technique as a risk factor for postoperative haemorrhage. Lancet 2004;364:697–702 Google Scholar
8 Söderman, AC, Odhagen, E, Ericsson, E, Hemlin, C, Hultcrantz, E, Sunnergren, O et al. Post-tonsillectomy haemorrhage rates are related to technique for dissection and for haemostasis. An analysis of 15734 patients in the National Tonsil Surgery Register in Sweden. Clin Otolaryngol 2015;40:248–54Google Scholar
9 Lowe, 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;117:717–24CrossRefGoogle ScholarPubMed
10 Tomkinson, A, Harrison, W, Owens, D, Harris, S, McClure, V, Temple, M. Risk factors for postoperative hemorrhage following tonsillectomy. Laryngoscope 2011;121:279–88Google Scholar
11 Perkins, JN, Liang, C, Gao, D, Shultz, L, Friedman, NR. Risk of post-tonsillectomy hemorrhage by clinical diagnosis. Laryngoscope 2012;122:2311–15Google Scholar
12 Achar, P, Sharma, RK, De, S, Donne, AJ. Does primary indication for tonsillectomy influence post-tonsillectomy haemorrhage rates in children? Int J Pediatr Otorhinolaryngol 2015;79:246–50Google Scholar
13 Windfuhr, JP, Chen, YS, Remmert, S. Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 2005;132:281–6Google Scholar
14 Sarny, S, Ossimitz, G, Habermann, W, Stammberger, H. Hemorrhage following tonsil surgery: a multicenter prospective study. Laryngoscope 2011;121:2553–60Google Scholar
15 Alexander, RJ, Kukreja, R, Ford, GR. Secondary post-tonsillectomy haemorrhage and informed consent. J Laryngol Otol 2004;118:937–40Google Scholar
16 Schrock, A, Send, T, Heukamp, L, Gerstner, AO, Bootz, F, Jakob, M. The role of histology and other risk factors for post-tonsillectomy haemorrhage. Eur Arch Otorhinolaryngol 2009;266:1983–7Google Scholar
17 Akin, RC, Holst, R, Schousboe, LP. Risk factors for post-tonsillectomy haemorrhage. Acta Otolaryngol 2012;132:773–7Google Scholar
18 Windfuhr, JP, Chen, YS. Incidence of post-tonsillectomy hemorrhage in children and adults: a study of 4,848 patients. Ear Nose Throat J 2002;81:626–8Google Scholar
19 Wikstén, J, Blomgren, K, Eriksson, T, Guldfred, L, Bratt, M, Pitkäranta, A. Variations in treatment of peritonsillar abscess in four Nordic countries. Acta Otolaryngol 2014;134:813–17CrossRefGoogle ScholarPubMed
20 Herbild, O, Bonding, P. Peritonsillar abscess. Arch Otolaryngol 1981;107:540–2Google Scholar
21 Kronenberg, J, Wolf, M, Leventon, G. Peritonsillar abscess: recurrence rate and the indication for tonsillectomy. Am J Otolaryngol 1987;8:82–4CrossRefGoogle ScholarPubMed
22 Herzon, FS.Harris, P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines. Laryngoscope 1995;105:1–17 Google Scholar
23 Wikstén, J, Hytönen, M, Pitkäranta, A, Blomgren, K. Who ends up having tonsillectomy after peritonsillar infection? Eur Arch Otorhinolaryngol 2012;269:1281–4Google Scholar
24 Fagan, JJ, Wormald, PJ. Quinsy tonsillectomy or interval tonsillectomy–a prospective randomised trial. S Afr Med J 1994;84:689–90Google ScholarPubMed
25 Windfuhr, JP, Chen, YS. Immediate abscess tonsillectomy–a safe procedure? Auris Nasus Larynx 2001;28:323–7Google Scholar
26 Lehnerdt, G, Senska, K, Jahnke, K, Fischer, M. Post-tonsillectomy haemorrhage: a retrospective comparison of abscess- and elective tonsillectomy. Acta Otolaryngol 2005;125:1312–17Google Scholar