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Evaluation of post-tonsillectomy hemorrhage and assessment of risk factors

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Tonsillectomy is one of the most common surgical procedures in otorhinolaryngology. Hemorrhage in the postoperative period has an incidence of up to 20% and is a potentially fatal complication. We aim to assess the incidence of hemorrhage after tonsillectomy in our institution, and to evaluate and identify the possible associated risk factors.

Methods

This retrospective study included 897 patients who underwent tonsillectomy between January 2015 and December 2018, 50.7% women and 49.3% men, aged between 2 and 83 years. No coagulopathies were identified. Comparison of age, gender, surgical indication, coagulation profile, concomitant adenoidectomy, surgical technique, surgeon’s experience and hemostasis method between groups with and without post-operative bleeding was made.

Results

Our incidence of post-tonsillectomy hemorrhage was 6%. Most patients (83.3%) had secondary bleeding (> 24 h after surgery). In 22.2% of the bleeding cases, it was necessary to revise the hemostasis in the operating room. Adulthood (age ≥ 18 years) (p < 0.001), INR values ≥ 1.2 (p = 0.014), aPTT values ≥ 35 s (p = 0.001), as well as concomitant adenoidectomy (p < 0.001) were the predictors of post-tonsillectomy bleeding.

Conclusion

Recognition of adult age, INR ≥ 1.2, aPTT ≥ 35 s and concomitant adenoidectomy as risk factors can be useful in identifying the patients at higher risk for bleeding complications.

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Authors and Affiliations

  1. Otolaryngology Department, Pedro Hispano Hospital, Matosinhos, Oporto, Portugal

    Ana Isabel Gonçalves, Catarina Rato, Ditza de Vilhena, Delfim Duarte, Gustavo Lopes & Nuno Trigueiros

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  1. Ana Isabel Gonçalves
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  2. Catarina Rato
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  3. Ditza de Vilhena
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  4. Delfim Duarte
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  5. Gustavo Lopes
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  6. Nuno Trigueiros
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Correspondence to Ana Isabel Gonçalves.

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The authors declare that the procedures followed are in accordance with the regulations established by the directors of the Commission for Clinical and Ethical Research and in accordance with the Helsinki Declaration of the World Medical Association.

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Gonçalves, A.I., Rato, C., de Vilhena, D. et al. Evaluation of post-tonsillectomy hemorrhage and assessment of risk factors. Eur Arch Otorhinolaryngol 277, 3095–3102 (2020). https://doi.org/10.1007/s00405-020-06060-1

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  • DOI: https://doi.org/10.1007/s00405-020-06060-1

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