Danish medical journal · 2012
Pain and bleeding are the main determinants of unscheduled contacts after outpatient tonsillectomy.
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Ovesen Therese, Kamarauskas Gintaras, Dahl Mads, Mainz Jan
Аннотация
INTRODUCTION: The objective of this prospective cohort study was to measure the medical technical quality of outpatient tonsillectomy in Danish ear, nose & throat practices by indicators, standards and prognostic factors.
MATERIAL AND METHODS: According to standardised and validated specific questionnaires, quality of surgery was measured in terms of postoperative bleeding, pain, gastrointestinal problems and infection.
RESULTS: A total of 614 patients were included. 11% were younger than four years, and 93% were observed for less than four hours. A total of 23% had unscheduled postoperative contacts. Almost 12% of the patients contacted a physician due to pain; a percentage that exceeds the chosen standard of 10%. 4% were hospitalised due to bleeding exceeding the chosen standard of 1%. Secondary haemostatic procedures were performed in 2% of the patients. The indication chronic tonsillitis, being an adult, and a postoperative observation shorter than four hours increased the risk of unscheduled contacts.
CONCLUSION: Outpatient tonsillectomy seems safe in Denmark. A minimum postoperative observation period of four hours will reduce the need for postoperative contacts. Because of the potentially life-threatening risk related to tonsillectomy, careful patient selection is mandatory and continuous monitoring of the quality of the procedure is essential.
FUNDING: Not relevant.
TRIAL REGISTRATION: Not relevant.
MATERIAL AND METHODS: According to standardised and validated specific questionnaires, quality of surgery was measured in terms of postoperative bleeding, pain, gastrointestinal problems and infection.
RESULTS: A total of 614 patients were included. 11% were younger than four years, and 93% were observed for less than four hours. A total of 23% had unscheduled postoperative contacts. Almost 12% of the patients contacted a physician due to pain; a percentage that exceeds the chosen standard of 10%. 4% were hospitalised due to bleeding exceeding the chosen standard of 1%. Secondary haemostatic procedures were performed in 2% of the patients. The indication chronic tonsillitis, being an adult, and a postoperative observation shorter than four hours increased the risk of unscheduled contacts.
CONCLUSION: Outpatient tonsillectomy seems safe in Denmark. A minimum postoperative observation period of four hours will reduce the need for postoperative contacts. Because of the potentially life-threatening risk related to tonsillectomy, careful patient selection is mandatory and continuous monitoring of the quality of the procedure is essential.
FUNDING: Not relevant.
TRIAL REGISTRATION: Not relevant.