Elizabeth Burckardt1, Whitney Rebholz2, Samantha Allen3, Elizabeth Cash4, Julie Goldman5. 1. Department of Otolaryngology-HNS and Communicative Disorders, University of Louisville School of Medicine, Louisville, KY, USA. Electronic address: emself01@louisville.edu. 2. Department of Otolaryngology-HNS and Communicative Disorders, University of Louisville School of Medicine, Louisville, KY, USA. Electronic address: whitney.rebholz@louisville.edu. 3. Department of Otolaryngology-HNS and Communicative Disorders, University of Louisville School of Medicine, Louisville, KY, USA. 4. Department of Otolaryngology-HNS and Communicative Disorders, University of Louisville School of Medicine, Department of Psychological & Brain Sciences, James Graham Brown Cancer Center, Louisville, KY, USA. Electronic address: Liz.Cash@louisville.edu. 5. Department of Otolaryngology-HNS and Communicative Disorders, University of Louisville School of Medicine, Louisville, KY, USA. Electronic address: Julie.Goldman@louisville.edu.
Abstract
OBJECTIVE: To determine risk factors and trends for posttonsillectomy hemorrhage (PTH) following adenotonsillectomy (T&A) at a single children's tertiary referral hospital. METHODS: Charts from all patients 2-12 years old undergoing T&A alone at a single children's hospital from January 1, 2010 through December 31, 2015 were reviewed. Data was collected on patient demographics, indication for procedure, time of year, academic affiliation of surgeon, surgical technique and method, post-operative pain medication prescribed,and readmission for PTH. Univariate chi-square analyses and logistic regression along with multivariable stepwise logistic regression were used to identify predictors of PTH. SPSS version 24 was used for statistical analyses with p < .05 indicating statistical significance. RESULTS: There were 2565 children undergoing T&A during the study period. One hundred seventy-three (6.7%) patients were readmitted, of which 53 (30.6%) were due to PTH. Univariate analyses identified children at the highest age quartile of the study, 7.72-12.97 years old (odds ratio [OR] = 5.775, 95% confidence interval [CI] = 2.248-14.837, p < .001) and children with a BMI z-score of 2 or greater (OR = 3.391, 95% CI = 1.497-7.680, p = .003) were at increased risk for PTH. Multivariable analyses also identified both the highest age quartile and BMI z-score of 2 or greater to be a risk factor for PTH. CONCLUSION: In children undergoing T&A, age greater than 7.72 years old and BMI z-score of 2 or greater are significant risk factors for PTH. Replication of these findings in a more highly powered trial is needed.
OBJECTIVE: To determine risk factors and trends for posttonsillectomy hemorrhage (PTH) following adenotonsillectomy (T&A) at a single children's tertiary referral hospital. METHODS: Charts from all patients 2-12 years old undergoing T&A alone at a single children's hospital from January 1, 2010 through December 31, 2015 were reviewed. Data was collected on patient demographics, indication for procedure, time of year, academic affiliation of surgeon, surgical technique and method, post-operative pain medication prescribed,and readmission for PTH. Univariate chi-square analyses and logistic regression along with multivariable stepwise logistic regression were used to identify predictors of PTH. SPSS version 24 was used for statistical analyses with p < .05 indicating statistical significance. RESULTS: There were 2565 children undergoing T&A during the study period. One hundred seventy-three (6.7%) patients were readmitted, of which 53 (30.6%) were due to PTH. Univariate analyses identified children at the highest age quartile of the study, 7.72-12.97 years old (odds ratio [OR] = 5.775, 95% confidence interval [CI] = 2.248-14.837, p < .001) and children with a BMI z-score of 2 or greater (OR = 3.391, 95% CI = 1.497-7.680, p = .003) were at increased risk for PTH. Multivariable analyses also identified both the highest age quartile and BMI z-score of 2 or greater to be a risk factor for PTH. CONCLUSION: In children undergoing T&A, age greater than 7.72 years old and BMI z-score of 2 or greater are significant risk factors for PTH. Replication of these findings in a more highly powered trial is needed.