Evaluation of Factors Associated with Post-Tonsillectomy Bleeding in Adults

IntroductionPost-tonsillectomy hemorrhage is one of the most common and potentially life-threatening complications of tonsillectomy in adults and may result in readmission or reoperation. Adults are known to have a higher bleeding risk compared with children due to increased inflammation, comorbid factors, and surgical complexity. Identification of factors associated with postoperative bleeding is essential for optimizing surgical technique, postoperative care, and patient counseling.Materials and MethodsThis retrospective case–control study included adult patients (≥۱۸ years) who underwent bilateral tonsillectomy at two tertiary referral hospitals between March ۲۰۲۱ and March ۲۰۲۳. Patients who developed post-tonsillectomy hemorrhage were compared with a matched control group without bleeding. Demographic characteristics, surgical indications, operative variables, and surgeon-related factors were evaluated. Post-tonsillectomy hemorrhage was defined as any postoperative pharyngeal bleeding confirmed by an otolaryngologist.ResultsAmong ۳۵۰ adult tonsillectomies, post-tonsillectomy hemorrhage occurred in ۵۴ patients (۱۵.۴%), predominantly secondary bleeding. In multivariate analysis, halitosis (p<۰.۰۰۱), chronic recurrent tonsillitis (p=۰.۰۰۱), sleep disturbances (p=۰.۰۰۱), use of sutures during the primary procedure (p=۰.۰۰۲), and surgeon experience (p=۰.۰۱۳) were independently associated with post-tonsillectomy hemorrhage. Tonsillolith showed a borderline association (p=۰.۰۵۴), while body mass index was not significant (p=۰.۷۴۸). No significant differences were observed in age, sex, smoking status, tonsillar hypertrophy grade, or operative duration (p>۰.۰۵). Most bleeding episodes occurred spontaneously (۵۹.۳%), and bleeding resolved without surgical intervention in ۶۶.۷% of cases.ConclusionSeveral patient- and surgery-related factors were associated with post-tonsillectomy hemorrhage in adults. Recognition of these associations may aid in perioperative risk assessment and postoperative management.

کلیدواژه ها:

Tonsillectomy ، Hemorrhage ، Tonsillitis ، Adult