Post-Tonsillectomy Bleeding: Incidence and Risk Factors Running Title: PTB: Incidence and Risk Factors

Abstract

ABSTRACTBackground: The most serious complication of tonsillectomy is hemorrhage. Primary post-tonsillectomy bleeding (PTB) occurs during the first 24 hours following the procedure. Secondary PTB occurs most frequently between the 5th-8th postoperative days.Aims: To evaluate the incidence of PTB and to elucidate any risk factors for such complication. Materials and methods: This retrospective cohort study reviewed the medical records of all patients who underwent tonsillectomy with or without adenoidectomy between 1/1/2008 and 12/31/2009 at the AL-Ramadi Teaching Hospital in AL-Ramadi, Iraq. Data on patient age, gender, reason for tonsillectomy, occurrence and timing of PTB were recorded. Results: Data were available for 2795 patients who underwent tonsillectomy or tonsillectomy and adenoidectomy during the study period. The incidence of PTB was1.2%. Seventy six point five percent was secondary bleeding while 23.5% was primary bleeding. The males were (61.8%), age group > 18 (64.7%) year and tonsillectomy for recurrent tonsillitis (44.1%) were more affected by bleeding. Seventy five percent of patients with primary and one patient (3.9%) with secondary bleeding have their bleeding controlled under general anesthesia (GA). Patients operated on by resident physicians were not more likely to have PTB than those operated on by attending surgeons. (P < 0.05)Conclusion: The overall incidence of PTB was 1.2%. Secondary bleeding was more common than primary bleeding. Significant risk factors for PTB included male gender, age older than 18 years, and tonsillectomy indicated for recurrent infection.