Evaluation of prevalence and risk factors of post adenotonsillectomy bleeding in Qazvin Qods hospital between 1393 to 1396

Background and Objective: According to different surgical indications such as infection and airway obstruction, adenotonsillectomy is considered as one of the most important operations in the world. Likewise other surgeries, this operation may also result in a variety of complications. The most common and life threatening complication is bleeding. This study was conducted to evaluate the prevalence of post adenotosillectomy bleeding and identifying the relevant factors and the necessity of preoperative coagulation profile screening which may result in achievement of more effective prevention methods. Materials and Methods: This prospective cross-sectional study was performed on all patients by census who had one of the indications of adenotonsillectomy (169) were referred to ENT clinic of Qazvin Quds hospital between 1393 to 1396. The exclusion criteria was the history of using anticoagulant agents, lack of patient’s collaboration. Patients profile including demographic data, surgery type and its indication, pre-operative coagulation profile and time of bleeding onset (first 12 hours, 12-24 hours, more than 24 hours after surgery) were documented in checklists which were arranged by researcher and were approved by board members of ENT department. Data was analyzed statistically by using SPSS version 19 and statistical test of chi-square and variance analysis. P -value less than 0.05 was considered statistically significant. Findings: Among 169 cases, 97 (57.5%) were female and 72 (42.6%) were male. The most commonly reported indications of the surgery were infection and night snoring which were accounted for 38.7% (65 patients) and 30.4 %(51 patiients) respectively. Post surgical bleeding occurred in 43.2% (73 patients) who were mostly upper 30 years old. Prevalence of primary and secondary bleeding were 13.6% and 87.6% respectively. No correlation was observed between preceding coagulation profile and post surgical bleeding (p=0.10). There was a statistically significant correlation between the surgical indications and bleeding (p=0.02), with the most bleeding in adenoid hypertrophy. Considering the sex, males were at the higher risk of bleding. Conclusion: In our study, the prevalence of post surgical bleeding has been reported higher in contrast to previous surveys. As the results clarified that there was no significant relation between preceding coagulation profile and post surgical bleeding, costly lab tests might better be replaced by precise patient’s history of bleeding disorders. The fact that the majority of reported bleeding were secondary, might shed light on he importance of post operative care and patient’s nutrition, especially in males and older cases.

Keywords:

adenotosillectomy , bleeding , risk factors