Post-tonsillectomy bleeding: how much is too much?

Complication rates become important in discussions for informed surgical consent and for quality assurance purposes. In an attempt to quantify literature-based rates for post-tonsillectomy bleeding, a MEDLINE search was carried out. Of 4,610 papers 63 reported post-tonsillectomy bleeding rates. The weighted mean, standard deviation and 95% confidence intervals were calculated for those papers. The mean (4.5%) plus 2 standard deviations (9.4%) suggests a maximum "expected" sustained bleeding rate of 13.9%. In the literature, which should reflect optimum results, there were 3 reports of bleed rates in the 18-20% range. These data may be useful for quality assurance committees and individual clinicians.