Artikel
Post-tonsillectomy Haemorrhage – a retrospective analysis of 490 Patients
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Autoren
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Stephanie Sarny
- Department of General Otorhinolaryngology, Head- and Neck Surgery, University of Graz, Graz, Austria
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Walter Habermann
- Department of General Otorhinolaryngology, Head- and Neck Surgery, Medical University Graz, Graz, Austria
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Christoph Schmid
- Department of General Otorhinolaryngology, Head- and Neck Surgery, Medical University Graz, Graz, Austria
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Guenther Ossimitz
- University of Klagenfurt, Klagenfurt, Austria
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Heinz Stammberger
- Department of General Otorhinolaryngology, Head- and Neck Surgery, Medical University Graz, Graz, Austria
| Veröffentlicht: | 22. Juli 2009 |
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Gliederung
Text
Introduction: Tonsillectomy is one of the most frequently performed surgical procedures in the field of otolaryngology. The main purpose of the study was to investigate the accuracy of re-admission rates following bleeding as a benchmark of haemorrhage rate in the community (i.e. actual rate versus hospital recorded rate).
Methods: We conducted a retrospective questionnaire based study of 695 patients. All patients who underwent tonsillectomy, adenotonsillectomy or tonsillotomy between January 2007 and June 2008 at the Medical University of Graz, Austria, were included. Main purposes of the study were the evaluation of frequency of preoperative tonsillitis, postoperative pain and haemorrhage rates. Haemorrhage was defined as any bleeding after extubation.
Results: Four hundred and seven patients returned the questionnaire (58.6 per cent). The study group comprised 251 adults (62 per cent) and 156 children (38 per cent) younger than fifteen years. One hundred patients (25 per cent) experienced postoperative bleeding. Re-admission rate following haemorrhage was 17.1 per cent. 21 out of 100 patients with postoperative haemorrhage had not returned to the hospital they were operated in: Nine patients did not seek medical advice, five attended ENT-specialists in private office and seven patients attended another hospital. A return to theatre because of haemorrhage was required in 4.7 per cent out of all operated patients (19 patients out of 407).
Summary: 4.7 per cent (19 patients out of 407) experienced post-tonsillectomy haemorrhage requiring surgical revision. This is well within the frame of reports in international literature. However, 25 per cent (100 patients) reported some kind of postoperative bleeding episode. We would have missed 7.9 per cent of these by assessing only the re-admission rate of patients suffering postoperative bleeding. We conclude that the haemorrhage rate is strongly related to the definition of postoperative bleeding and the study design and is significantly more frequent than assumed before.
References
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