Risk factors for secondary post-tonsillectomy hemorrhage in children

Objective: The purpose of this study was to investigate the secondary post-tonsillectomy hemorrhage (PTH) rate in the pediatric population undergoing cold dissection tonsillectomy and to evaluate its clinical risk factors.

Methods: This retrospective case-control study comprised pediatric tonsillectomy cases admitted to the tertiary otorhinolaryngology clinic between January 2007 and June 2017. Risk factors were compared between the PTH and non-PTH groups, including surgical diagnosis, preoperative demographic and clinical characteristics, surgeon skill level, and hemostasis methods during tonsillectomy (intraoperative bipolar electrocautery and suture ligation).

Results: In the last decade, tonsillectomy had been performed in 4122 pediatric cases using the cold dissection method. The number of secondary PTH cases was 89 (2.16%), and significant risk factors for secondary PTH were male sex (p<0.021), age (≥13 years, p<0.008), environmental tobacco smoke exposure at home (p<0.000), attention deficit hyperactivity disorder (p<0.011), and hemostasis with intraoperative bipolar electrocautery (p<0.000).

Conclusion: Male children aged ≥13 years whose pre-tonsillectomy history included environmental tobacco smoke exposure at home and hyperactivity disorder and who had undergone hemostasis with bipolar electrocautery during tonsillectomy were at significant risk for secondary PTH.

Cite this article as: Gümüşsoy M, Çukurova I. Risk factors for secondary post-tonsillectomy hemorrhage in children. B-ENT 2020; 16(1): 36-40.