Post-tonsillectomy hemorrhage incidence: comparison between day case and in-patient surgery

Abstract

Background: Day-case tonsillectomy is getting popularity these days because of low risk of nosocomial infections and low cost. The aim of this study was to evaluate the incidence of post-tonsillectomy hemorrhage in day-case compared to conventional in-patient surgery.

Methods: This comparative study was conducted at Department of ENT, DHQ Teaching Hospital, D.I.Khan, from January 2008 to December 2010. Patients with history of recurrent episodes of tonsillitis were included. Exclusion criteria included children less than 5 years, any nasal pathology, history of acute tonsillitis within six weeks and bleeding diathesis. The sample consisted of 450 patients divided into two groups. One group was kept in the hospital for 8 hours after surgery and labeled as the day case group while other kept for 24 hours and labeled as in-patient group. Tonsillectomy was performed by dissection method. Statistical analysis concerning comparison of incidence of hemorrhage between the two groups was performed with student t-test.

Results: Post-tonsillectomy hemorrhage was seen in 12(2.65%) patients; 5(2.2%) in the inpatient group while 7(3.1%) in daycase group (p=0.18). Incidence of primary hemorrhage was 2/12 (16.65%) and secondary hemorrhage 10/12 (83.35%).

Conclusion: Tonsillectomy can safely be performed as day-case procedure as there is no significant difference of post-tonsillectomy hemorrhage between day-case and inpatient procedures.