Analysis Of Related Causes Of Post-tonsillectomy Hemorrhage

Objective:To provide evidence for decreasing the incidence of post-tonsillectomy hemorrhage, related factors of patients experiencing tonsillectomy were retrospectively reviewed.Methods:598 patients who were treated between January of 2005 to March of 2015 with a minimum follow-up of 1 month were retrospectively reviewed. Patients with tonsillectomy were divided into two according to post-tonsillectomy hemorrhage occurring or not. Fourteen factors including sex, age, diagnosis, habits of smoking and drinking, underlying diseases, preoperative examination, Surgical, surgical resection, Homeostasis method, anesthesia, the surgeon qualifications, operative time,blood type were analyzed. Chi square tests were used to compared the rate of hemorrhage in different factor groups. Monofactor and multivariate logistic regression were used to explore the risk factors of post-tonsillectomy hemorrhage. SSPS 10.0 were applied to do the statistical analysis.Results:The incidence of post-tonsillectomy hemorrhage was different between different age groups. The rate of hemorrhage in adult group was much higher than that in under age group and the difference was significant(X2=9.044, P=0.03). One factor logistic regression showed that age was the risk factors of post-tonsillectomy hemorrhage(P=0.06) Multivariate logistic regression demonstratedthat the age was the independent risk factors of post-tonsillectomy hemorrhage(P=0.013 < 0.05). Compared to under age children, the adults had approximately 4 times odds of hemorrhage(P=0.013).Conclusion:Age was the independent risk factors of post-tonsillectomy hemorrhage. The adult patients were associated with much more hemorrhages. It is suggested that in adult patients more care should be taken to the range of indication of tonsillectomy, the hemostasis and the nursing after the operation. Since the coblation might increase the incidence of secondary hemorrhage rate, we recommended to consider the age of the patients and the pathologic type of their tonsils before coblation application in the operation.