[Post-tonsillectomy hemorrhage: incidence and risk factors].

Introduction: The aim of this study was to quantify the incidence and evaluate the risk factors of post-tonsillectomy hemorrhage (PTH).
Materials and Methods: A retrospective study was performed of all patients with PTH at the three hospital departments in Aarhus County, Denmark (650,000 inhabitants), and a random sample of one-third of all tonsillectomised patients at Aarhus University Hospital (AS) in the period 1 December 2002 to 30 November 2003, during which period 918 patients were tonsillectomised.
Results: Post-operative haemorrhage occured in a total of 48 patients (5.2%). Twenty-six patients (2.8%) needed re-operation: 12 (3.4%) at AS, 7 (3.7%) at Randers Centralsygehus (RCS) and 7 (1.8%) at Silkeborg Centralsygehus (SCS). The following factors correlated significantly with PTH: high age (p = 0.0093), greater perioperative blood loss (p = 0.026) and high perioperative blood pressure (p = 0.0007). In addition, we found a three times higher but insignificant (p = 0.26) risk during abscess tonsillectomy as compared to cold tonsillectomy.
Conclusion: The three ENT departments of Aarhus County fulfil international standards, but the operation has a high complication rate, which emphasizes the importance of solid indications for operation. In light of the increased risk of PTH with higher age, the instructions at AS have been altered so that all patients over 20 years of age with peritonsillar abscess who can cooperate are treated with aspiration and incision.