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Keywords:

  • Tonsillectomy;
  • tonsillotomy;
  • postoperative hemorrhage;
  • ambulatory surgery;
  • outcome assessment (healthcare);
  • quality assurance (healthcare);
  • Level of Evidence: 2b.

Abstract

Objectives/Hypothesis:

To analyze the incidence of primary bleeding following tonsil surgery and to evaluate risk factors.

Study Design:

Register study of the results from the National Tonsil Surgery Register in Sweden covering the period 1997 to 2008 and 54,696 operations.

Methods:

Data were collected by means of three questionnaires, two filled in by professionals and one 6 months postoperatively by the patient/parent.

Results:

A total of 719 patients experienced primary postoperative bleeding during the hospital stay (1.3%). A number of independent factors were correlated with decreased risk of post-tonsillectomy hemorrhage: younger age (P < .0001), female sex (P < .0001), type of surgery (tonsillotomy) (P = .0006), and surgery performed on a day-surgery basis (P < .0001). Indication for surgery and number of operations performed at the department did not correlate with postoperative bleeding risk. A significant decrease in primary postoperative hemorrhage rate from 2% to 0.96% was found during the study period.

Conclusions:

Primary hemorrhage following tonsil surgery is rare. During the study period, a significant decrease in primary bleeding rates occurred. The changes in practice with an increasing proportion of day-surgery cases and tonsillotomy have contributed to the reduced risk, but cannot completely explain the reduction.