Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2026
High Bleeding Rates After Tonsil Surgery in Denmark and Opportunities for Quality Improvement.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mølhave Martin, Lyhne Nina M, Nielsen Susanne H, Hahn Pernille, Holm Jesper K, Ovesen Therese
Аннотация
OBJECTIVES: To examine postoperative bleeding rates and associated patient and surgical factors after tonsil surgery in Denmark and identify targets for quality improvement.
DESIGN: Multicentre cohort study using prospectively collected registry data.
SETTING: Five Danish ENT departments contributing to the Danish Tonsil Database, 2018-2024.
PARTICIPANTS: Children, adolescents and adults undergoing tonsillectomy, adenotonsillectomy, tonsillotomy, adenotonsillotomy or acute tonsillectomy for benign indications.
MAIN OUTCOME MEASURES: Clinically confirmed postoperative bleeding within 30 days. Modified Poisson regression with robust standard errors estimated adjusted relative risks (RRs).
RESULTS: Among 6145 procedures, postoperative bleeding occurred after 14% of tonsillectomies, 9.9% of adenotonsillectomies, 10% of acute tonsillectomies, 1.7% of tonsillotomies and 2.6% of adenotonsillotomies. Among bleeding events, 51% required general anaesthesia, 32% local anaesthesia and 17% resolved spontaneously. After tonsillectomy, male sex (adjusted RR 1.69, 95% CI 1.44-2.00) and resident surgery (adjusted RR 1.25, 95% CI 1.04-1.51) were associated with higher risk, while patients aged < 12 years (adjusted RR 0.53, 95% CI 0.37-0.74) and 12-17 years (adjusted RR 0.57, 95% CI 0.43-0.76) had lower risk than adults. Cold dissection with cold haemostasis tonsillectomy had the lowest crude bleeding rate (9.8%), but operative technique was not independently associated with bleeding after adjustment. No deaths occurred.
CONCLUSIONS: Bleeding rates after tonsillectomy were higher than those reported in several international cohorts, while rates after tonsillotomy were low. Cold dissection with cold haemostasis tonsillectomy had the lowest observed rate, although adjusted analyses were not statistically significant. These findings support structured quality-improvement work and continued monitoring.
DESIGN: Multicentre cohort study using prospectively collected registry data.
SETTING: Five Danish ENT departments contributing to the Danish Tonsil Database, 2018-2024.
PARTICIPANTS: Children, adolescents and adults undergoing tonsillectomy, adenotonsillectomy, tonsillotomy, adenotonsillotomy or acute tonsillectomy for benign indications.
MAIN OUTCOME MEASURES: Clinically confirmed postoperative bleeding within 30 days. Modified Poisson regression with robust standard errors estimated adjusted relative risks (RRs).
RESULTS: Among 6145 procedures, postoperative bleeding occurred after 14% of tonsillectomies, 9.9% of adenotonsillectomies, 10% of acute tonsillectomies, 1.7% of tonsillotomies and 2.6% of adenotonsillotomies. Among bleeding events, 51% required general anaesthesia, 32% local anaesthesia and 17% resolved spontaneously. After tonsillectomy, male sex (adjusted RR 1.69, 95% CI 1.44-2.00) and resident surgery (adjusted RR 1.25, 95% CI 1.04-1.51) were associated with higher risk, while patients aged < 12 years (adjusted RR 0.53, 95% CI 0.37-0.74) and 12-17 years (adjusted RR 0.57, 95% CI 0.43-0.76) had lower risk than adults. Cold dissection with cold haemostasis tonsillectomy had the lowest crude bleeding rate (9.8%), but operative technique was not independently associated with bleeding after adjustment. No deaths occurred.
CONCLUSIONS: Bleeding rates after tonsillectomy were higher than those reported in several international cohorts, while rates after tonsillotomy were low. Cold dissection with cold haemostasis tonsillectomy had the lowest observed rate, although adjusted analyses were not statistically significant. These findings support structured quality-improvement work and continued monitoring.