Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T03:30:43.265Z Has data issue: false hasContentIssue false
  • English
  • Français

Post-tonsillectomy morbidity statistics: are they underestimated?

Published online by Cambridge University Press:  19 March 2007

J Doshi ,
M Damadora ,
S Gregory  and
S Anari
J Doshi*
Affiliation:
Department of Otolaryngology, Darlington Memorial Hospital, UK
M Damadora
Affiliation:
Department of Otolaryngology, Darlington Memorial Hospital, UK
S Gregory
Affiliation:
Department of Otolaryngology, Darlington Memorial Hospital, UK
S Anari
Affiliation:
Department of Otolaryngology, Darlington Memorial Hospital, UK
*
Address for correspondence: Mr Jayesh Doshi, Apartment 20, Adderstone Court, 17 Adderstone Crescent, Jesmond, Newcastle upon Tyne NE2 2EA, UK. Fax: 01706 646734 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Post-tonsillectomy morbidity statistics are obtained when patients present to hospital with complications. The two common morbidities are pain and haemorrhage. Hospital-recorded morbidity rates may be an underestimation, as some patients are treated by general practitioners and are therefore not included in hospital audits.

Methods:

Prospective, cohort, questionnaire study to assess: the post-tonsillectomy haemorrhage rate (i.e. actual rate versus hospital recorded rate); and the number of patients with post-operative pain and/or bleeding who were treated with antibiotics by their general practitioner.

Results:

The response rate was 76 per cent (70/92). The actual rate of secondary haemorrhage was three times that noted in the hospital records (15.7 vs 5.7 per cent, respectively). Fifteen patients (21 per cent) required extra analgesia after discharge. General practitioners prescribed antibiotics for pain alone in six patients (11 per cent).

Conclusion:

The actual post-tonsillectomy haemorrhage rate is much higher than that recorded in hospital statistics. General practitioners differ in their treatment of post-tonsillectomy patients presenting with pain alone; some prescribe antibiotics in addition to analgesia.

Keywords

TonsillectomyPostoperative ComplicationsMedical Audit
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 4 , April 2008 , pp. 374 - 377
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster at the North of England ENT Society meeting, 10 March 2006, York, and at the 12th British Academy Conference in Otolaryngology and ENT Expo meeting, 5–7 July 2006, Birmingham, UK. Oral Presentation at the Midlands Insitute of Otology meeting 5 January 2007, Sloke-on-Trent, UK.

References

1 O'Reilly, BJ, Black, S, Fernandes, J, Panesar, J. Is the routine use of antibiotics justified in adult tonsillectomy? J Laryngol Otol 2003;117:382–285CrossRefGoogle ScholarPubMed
2 Ghufoor, K, Frosh, A, Sandhu, G, Hanif, J. Post tonsillectomy patient care in the community. Int J Clin Prac 2000; 54:420–3CrossRefGoogle ScholarPubMed
3 Kuo, M, Hegarty, D, Johnson, A, Stevenson, S. Early post-tonsillectomy morbidity following hospital discharge: do patients and GPs know what to expect? Health Trends 1995;27:98–100Google ScholarPubMed
4 Windfuhr, J, Sheehafer, M. Classification of haemorrhage following tonsillectomy. J Laryngol Otol 2001;115:457–61CrossRefGoogle ScholarPubMed
5 Cowan, D, Hibbert, J. Acute and chronic infection of the pharynx and tonsils. In: Kerr, A, ed. Scott-Brown's Otolaryngology, 6th edn. London: Butterworth Heinemann, 1995;1–24Google Scholar
6 Handler, S, Miller, L, Richmond, K, Baranak, C. Post-tonsillectomy haemorrhage: incidence, prevention and management. Laryngoscope 1986;96:1243–7CrossRefGoogle ScholarPubMed
7 Colreavy, M, Nanan, D, Benamer, M, Donnelly, M, Blaney, A, O'Dwyer, T et al. Antibiotic prophylaxis post-tonsillectomy: is it of benefit? Int J Paed Otolaryngol 1999;50:15–22CrossRefGoogle ScholarPubMed
8 Gaffney, R, Cafferkey, M. Bacteriology of normal and diseased tonsils assessed by fine needle aspiration: Haemophilus influenzae and the pathogenesis of recurrent acute tonsillitis. Clin Otolaryngol 1998;23:181–5CrossRefGoogle ScholarPubMed
9 Telian, S, Handler, S, Fleisher, G, Baranak, C, Wetmore, R, Potsic, W. The effect of antibiotic therapy on recovery after tonsillectomy in children. Arch Otolaryngol Head Neck Surg 1986;112:610–15CrossRefGoogle Scholar
10 Lee, WC, Duignan, MC, Walsh, RM, McRae-Moore, JR. An audit of prophylactic antibiotic treatment following tonsillectomy in children. J Laryngol Otol 1996;110:357–9CrossRefGoogle ScholarPubMed
11 Benson-Mitchell, R, Maw, A. Assessment of sequelae at home following adenotonsillectomy. A basis for day-case management? Clin Otolaryngol 1993;18:282–4CrossRefGoogle ScholarPubMed
12 Raut, V. Bipolar scissors versus cold dissection tonsillectomy: a prospective, randomised, multi-unit study. Laryngoscope 2001;111:2178–82CrossRefGoogle ScholarPubMed
13 Valtonen, H, Qvarnberg, Y, Blomgren, K. Patient contact with healthcare professsionals after elective tonsillectomy. Acta Otolaryngol 2004;124:1086–9CrossRefGoogle Scholar
14 Jones, T, Temple, R, Morar, P, Roland, N, Rogers, J. General practitioner consultations after a paediatric tonsillectomy. Int J Paed Otolaryngol 1997;39:97–102CrossRefGoogle ScholarPubMed
15 Murthy, P, Laing, MR. Dissection tonsillectomy: pattern of postoperative pain, medication and resumption of normal activity. J Laryngol Otol 1998;112:41–4CrossRefGoogle ScholarPubMed
16 Palme, CE, Tomasevic, P, Pohl, DV. Evaluating the effects of oral prednisolone on recovery after tonsillectomy: a prospective, double blind, randomized trial. Laryngoscope 2000;110:2000–4CrossRefGoogle ScholarPubMed
17 Toma, A, Blanshard, J, Eyon-Lewis, N, Bridger, M. Post tonsillectomy pain: the first ten days. J Laryngol Otol 1995:109:963–4CrossRefGoogle ScholarPubMed