Post-tonsillectomy Hemorrhage: A Seven-year Retrospective Study

Introduction: Post-tonsillectomy hemorrhage (PTH) is a serious complication that sometimes requires immediate surgical interventions. The present study aimed to assess the association between patients’ age, the time of onset of PTH, and the need for surgery to control bleeding. Materials and Methods: All patients with PTH were retrospectively admitted to two tertiary hospitals in Mashhad, during ۲۰۱۲-۲۰۱۹. Hospital records were investigated to select eligible cases and retrieve their characteristics such as demographics, source and time of bleeding, and type of intervention. Chi-square, independent samples T-test, and binary logistic regression were used as research tools. Results: A total of ۲۲۷ patients with PTH and a mean age of ۱۴.۹۹±۱۰.۳۴ years were studied, of whom ۱۲۸ (۵۶.۴%) were male and ۶۳ (۲۷.۸%) required surgery to control PTH. The mean onset of PTH was ۸.۱۴±۳.۴۷ days after the surgery and in ۵۹ cases (۲۶.۵%) was the seventh day. Those patients aged ۶ years or older in whom PTH occurred during the first postoperative week were significantly more likely to need surgery to control it (P= ۰.۰۳۴). Adult (OR= ۴.۰۳۲, ۹۵%CI= ۱.۹۳۲-۸.۴۱۴,     p <۰.۰۰۱), bleeding from both tonsils (OR= ۲.۳۸۰, ۹۵%CI= ۱.۰۳۲-۵.۴۸۷, P= ۰.۰۴۲), and receiving blood transfusion (OR= ۷.۹۳۴, ۹۵%CI= ۲.۰۰۳-۳۱.۴۲۲, P= ۰.۰۰۲) were independent predictors of the need for surgical treatment to control PTH. Conclusion: PTH within the first postoperative week in patients older than ۶ years, adults, bleeding from both tonsils, and receiving a blood transfusion is recommended to be considered as a potential predictor of the need for surgery.

Keywords:

complication , Hemorrhage , Tonsillectomy