Posttonsillectomy hemorrhage - What is it and what should be recorded?

Objectives: To report on our incidence of posttonsillectomy hemorrhage and to define what constituted posttonsillectomy bleeding. Design: Retrospective study. Setting: Tertiary care children's hospital and a local satellite facility. Patients: A series of 1438 consecutive patients who had undergone either to nsillectomy or adenotonsillectomy between January 1, 1999, and December 31, 1999, Intervention: During this period, parents were instructed to return with th eir children for clinical evaluation if any blood was seen in the postopera tive period. Main Outcome Measures: Postoperative day of evaluation, age, sex, location of bleeding, management strategy, length of hospital admission, and any ble eding disorders were noted for each patient. Results: A total of 112 patients underwent evaluation 134 times. Of these p atients, 96 required only 1 evaluation and 16 required more than 1 evaluati on. All patients who had more than 1 evaluation required intervention. The total number of children requiring intervention for posttonsillectomy hemor rhage was 51 (3.5%) of the 1438 patients. Female patients were more likely than male patients to return for evaluation. Patients who were 12 years and older were the most likely and those 3 years and younger were the least li kely to have posttonsillectomy hemorrhage. The most common time from surger y to initial evaluation for hemorrhage was 6 days. Conclusions: By reviewing our own criteria for defining and recording postt onsillectomy hemorrhage, we conclude that posttonsillectomy hemorrhage is d efined differently in the literature. This supports the need for a standard definition to allow for direct comparisons.