Post-tonsillectomy hemorrhage: cost-benefit analysis of prolonged hospitalization

Vyskocil, Erich; Baumgartner, Wolf‐Dieter; Grasl, Matthäus Ch.; Grasl, Stephan; Arnoldner, Christoph; Steyrer, Johannes; Erović, Boban M.

doi:10.1080/00016489.2020.1746829

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…According to published literature [7,8], the highest frequency of PTH is around postoperative days 5-7, which could be confirmed in our patient population. After the scientific community had gained initial insights into the occurrence of PTH, concepts of postoperative management after tonsillectomy were implemented at many centres, yet several unknowns and regional differences remained.…”

Section: Discussionsupporting

confidence: 86%

“…Among those affected by such an event, up to 5% experience severe PTH with a need for surgical revision under general anaesthesia [1,[4][5][6]. Primary PTH occurs within the first 24 h postoperatively and is mainly attributed to surgical factors, while secondary PTH typically begins 5-10 days postoperatively [1,[4][5][6][7][8]. Although the aetiology of PTH is not completely understood, increased efforts are being made to better grasp relevant factors for PTH and subsequently reduce morbidity and mortality [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Temporal fluctuations of post-tonsillectomy haemorrhage

Grasl

Mekhail

Janik

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff. Methods This retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney U test, and Chi-square goodness of fit tests were used to detect potential differences. Results A total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: < 1–19) days. 64.7% (n = 194) of all emergency surgeries had to be performed during evening and night hours (6 pm—6 am) (p < 0.0001). Compared to diurnal incidents, the risk of a nocturnal PTH event increased, the longer ago the initial surgery was (p < 0.0001). No seasonal variations were identified. Age, sex, and details of the initial procedure had no significant influence on the start time according to the surgical protocol. Conclusion The discovered temporal fluctuations of PTH are of relevance for patient awareness and preoperative education. Due to possible life-threatening complications, management of severe PTH requires specific resources and trained medical staff on call.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Temporal fluctuations of post-tonsillectomy haemorrhage

Grasl

Mekhail

Janik

et al. 2021

Eur Arch Otorhinolaryngol

Self Cite

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The relationship between posttonsillectomy bleeding to hemogram and coagulation parameters

Güllüev,

Yücel,

Demirci

et al. 2024

Eur Arch Otorhinolaryngol

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The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

Masoudifar,

Rezaeian,

Mosharaf

2023

Advanced Biomedical Research

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Background: Considering the high prevalence of tonsillectomy in children and concerns of postoperative management, this study was conducted with the aim of evaluating the effects of oxymetazoline on bleeding, cough, and sore throat in children undergoing tonsillectomy. Materials and Methods: The current double-blind clinical trial study was conducted on 88 tonsillectomy candidate patients. These patients were randomly divided into two groups. In the first group, oxymetazoline 0.05% nasal spray (OXY group) and in the second group, distilled water spray (Control group) was prescribed as one puff in each nostril immediately after anesthesia induction., the nasal spray was prescribed again in both nostrils at 12 h after tonsillectomy. Then the hemodynamic parameters, post-tonsillectomy hemorrhage (PTH) and sore throat were evaluated. Results: The mean of the sore throat of children was not significantly different between the two groups in any of the follow-up times ( P value >0.05). PTH in recovery and in the ward in the OXY group with the mean of 57.60 ± 71.82 ml and 22.11 ± 22.50 ml, respectively, was significantly lower than the control group (83.50 ± 113.64 ml and 27.52 ± 35.11 ml) ( P value < 0.05). Also, the frequency of cough in the ward in the OXY group with 27.3% was significantly lower than the control group with 56.8% ( P value = 0.005). Conclusion: Regarding the results of the present study, sore throat and hemodynamic parameters did not change significantly with the administration of oxymetazoline. But this drug has played a significant role in reducing PTH and cough in children.

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Post-tonsillectomy hemorrhage: cost-benefit analysis of prolonged hospitalization

Cited by 4 publications

References 17 publications

Temporal fluctuations of post-tonsillectomy haemorrhage

Temporal fluctuations of post-tonsillectomy haemorrhage

The relationship between posttonsillectomy bleeding to hemogram and coagulation parameters

The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

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