Benchmarking surgery: secondary post-tonsillectomy hemorrhage 1999-2005

Conclusions. We found no evidence that the reported increase in otolaryngologic surgery in Norway in recent years has affected post-tonsillectomy hemorrhage rates, and suggest that the latter is a valuable benchmark for the quality of the tonsillectomies and adenotonsillectomies nationwide. Objectives. To estimate the incidence of post-tonsillectomy hemorrhage and assess the distribution of hospitalizations for post-hemorrhage bleeding and surgery. Materials and methods. This was a national study using data from the Norwegian Patient Registry 1999-2005 with complete information on the incidence of post-hemorrhage hospitalizations, rebleeding surgery, and (adeno)tonsillectomy rates. Results. One patient per 200 tonsillectomies was hospitalized and 1 per 1000 operated for post-tonsillectomy hemorrhage during the study period. Of the 328 patients hospitalized, 64 (20%) required surgery under general anesthesia. Peak age was 5-9 years; 194 (59%) with post-tonsillectomy hemorrhage were males. The mean rebleeding rate was 0.5% (confidence interval (CI)=0.5-0.6) when secondary rebleeding was estimated as the proportion of all tonsillectomies. While tonsillar surgery was more frequent in the non-adult population, post-tonsillectomy surgery was equally common in the ages below and above 16 years. Seasonal variation in post-tonsillectomy hemorrhages was not found.