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Posttonsillectomy Hemorrhage
What Is It and What Should Be Recorded?
James H. Liu, MD;
Kristofer E. Anderson, MD;
J. Paul Willging, MD;
Charles M. Myer III, MD;
Sally R. Shott, MD;
Glenn O. Bratcher, MD;
Robin T. Cotton, MD
Arch Otolaryngol Head Neck Surg. 2001;127:1271-1275.
Objectives To report on our incidence of posttonsillectomy hemorrhage and to define
what constituted posttonsillectomy bleeding.
Design Retrospective study.
Setting Tertiary care children's hospital and a local satellite facility.
Patients A series of 1438 consecutive patients who had undergone either tonsillectomy
or adenotonsillectomy between January 1, 1999, and December 31, 1999.
Intervention During this period, parents were instructed to return with their children
for clinical evaluation if any blood was seen in the postoperative period.
Main Outcome Measures Postoperative day of evaluation, age, sex, location of bleeding, management
strategy, length of hospital admission, and any bleeding disorders were noted
for each patient.
Results A total of 112 patients underwent evaluation 134 times. Of these patients,
96 required only 1 evaluation and 16 required more than 1 evaluation. All
patients who had more than 1 evaluation required intervention. The total number
of children requiring intervention for posttonsillectomy hemorrhage was 51
(3.5%) of the 1438 patients. Female patients were more likely than male patients
to return for evaluation. Patients who were 12 years and older were the most
likely and those 3 years and younger were the least likely to have posttonsillectomy
hemorrhage. The most common time from surgery to initial evaluation for hemorrhage
was 6 days.
Conclusions By reviewing our own criteria for defining and recording posttonsillectomy
hemorrhage, we conclude that posttonsillectomy hemorrhage is defined differently
in the literature. This supports the need for a standard definition to allow
for direct comparisons.
From the Department of Pediatric Otolaryngology–Head and Neck
Surgery, Children's Hospital Medical Center, the University of Cincinnati
Medical Center, Cincinnati, Ohio. Dr Liu is now in private practice with Texas
ENT Specialists, PA, Houston.
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