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Secondary post-tonsillectomy haemorrhage: is there evidence of diurnal and monthly variation in haemorrhage rates?

Published online by Cambridge University Press:  26 September 2022

H R Lancer Open the ORCID record for H R Lancer [Opens in a new window] ,
T Beech  and
M Weller
H R Lancer*
Affiliation:
Department of Otolaryngology, Russells Hall Hospital, Dudley Group Foundation Trust, Dudley, UK
T Beech
Affiliation:
Department of Otolaryngology, University Hospitals Birmingham, Birmingham, UK
M Weller
Affiliation:
Department of Otolaryngology, Russells Hall Hospital, Dudley Group Foundation Trust, Dudley, UK
*
Author for correspondence: Miss Hannah R Lancer, Department of Otolaryngology, Russells Hall Hospital, Pensnett Road, Dudley DY1 2HQ, UK E-mail: [email protected]
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Abstract

Background

Anecdotally, secondary post-tonsillectomy haemorrhage tends to occur out-of-hours. This study sought to establish whether there is a link between haemorrhage and time of day, and examined correlations with month and with monthly temperature.

Methods

Data were obtained for patients in our hospital undergoing surgical arrest of secondary post-tonsillectomy haemorrhage between January 2002 and December 2020. Haemorrhage timing was categorised into daytime (07:00–18:00), evening (18:00–22:00) and overnight (22:00–07:00). The chi-square test was used to assess diurnal and monthly variation in haemorrhage rates (p < 0.05). Pearson's correlation test was used to analyse monthly haemorrhage rates and average monthly temperature.

Results

Fifty per cent of patients suffered post-tonsillectomy haemorrhage overnight and 28.1 per cent haemorrhaged in the evening, representing a significant difference (p = 0.018). The highest rate of haemorrhage was in July (2.96 per cent), which was statistically significant (p = 0.0024). There was a positive correlation between average monthly temperature and haemorrhage rate (Pearson's correlation = 0.478, p = 0.116004), although this was not significant.

Conclusion

Most post-tonsillectomy haemorrhages occur out-of-hours (78.1 per cent), which could be conveyed during the consent process. The haemorrhage rate is lower in winter, which may influence planned operating theatre scheduling.

Keywords

TonsillectomyPostoperative HemorrhagePostoperative ComplicationsReoperation
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 9 , September 2023 , pp. 1017 - 1021
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Miss H R Lancer takes responsibility for the integrity of the content of the paper

Presented as a poster at the Midlands Institute of Otorhinolaryngology Winter Meeting, 17 January 2020, online.

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