Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients

Otolaryngol Head Neck Surg. 2005 Feb;132(2):281-6. doi: 10.1016/j.otohns.2004.09.007.

Abstract

Objective: To evaluate potential risk factors and the incidence of bleeding following adenoidectomy or tonsillectomy, with or without adenoidectomy requiring surgical treatment under general anesthesia.

Study design and setting: Retrospective chart review of 15,218 patients who underwent surgery between January 1, 1988, and September 30, 2001, at our institution (St. Anna Hospital, Duisburg).

Results: A total of 229 patients experienced postoperative bleeding (1.5%). Patients of male gender and 70 years of age or older were significantly at risk for post-tonsillectomy hemorrhage. The incidence of bleeding increased with age. Of the bleeding episodes, 76% occurred on the day of surgery; immediate abscess-tonsillectomy was not associated with an increased risk of bleeding.

Conclusions: Hemorrhage following tonsillectomy and adenoidectomy is rare and predominantly occurs early after surgery. Male patients, 70 years of age or older, infectious mononucleosis, and a history of recurrent tonsillitis were identified as risk factors for post-tonsillectomy hemorrhage. Delayed hemorrhage has the potential to be life-threatening.

MeSH terms

  • Adenoidectomy / adverse effects*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, General
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology*
  • Postoperative Hemorrhage / surgery
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tonsillectomy / adverse effects*