Artikel
Bleeding complications following tonsillectomy after shortening the period of hospitalization
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Autoren
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Tobias Müllerklein
- Johannes Wesling Klinikum, Minden, Germany
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Birgit Lieberum
- Johannes Wesling Klinikum, Minden, Germany
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Martin Schrader
- Johannes Wesling Klinikum, Minden, Germany
| Veröffentlicht: | 30. Juli 2013 |
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Gliederung
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Introduction: Due to financial reasons hospitals aspire to reduction in length of hospital stay in order to increase hospital admissions and revenue. Although about 100,000 tonsillectomies are performed in Germany annually, the rate of postoperative complications and length of hospital stay is quite low making this operation socially and economically relevant. However caution is necessary due to possibility of severe bleedings.
Method und results:
Study design: Retrospective:
The study consists of two groups: Group A: n=531 patients, length of hospital stay (LOS): 5 days. Group B: n=434 patients: LOS: 3 days. Surgical technique: Cold steel dissection with accurate bipolar coagulation for hemostasis. Classification: Every bleeding after extubation was included.
Postoperative hemorrhage: Group A: 11.9%; 7.5% of the patients were treated with bipolar coagulation, 4.9% of them under general anesthetic. Group B: 16.8%; 6.2% were treated with bipolar coagulation, 3.7% under general anesthetic.
Discussion: After shortening the duration of hospital stay, we observed a significant increase of postoperative bleedings. However the bleedings that required treatment under general anesthesic, decreased insignificantly from 4.9 to 3.7%.
Although the entirety of bleedings increased, the necessity of surgical revision decreased. Thus we conclude that the shortening of hospital duration by two days does not increase the risk of the patients safety, especially due to the fact, that no serious complications occured.
