Diurnal variation of post-tonsillectomy haemorrhage.

Abstract

Introduction: Post-tonsillectomy haemorrhage (PTH) is typically self-limiting but may require medical intervention or surgery. PTH is classified as either primary (within 24 hours) or secondary (after 24 hours). Secondary haemorrhage is often linked to eschar sloughing, though the exact cause remains unclear. Secondary PTH is often an out-of-office-hour event. We aimed to investigate the diurnal variations of PTH in a Danish cohort.

Methods: This retrospective cohort study recruited patients from ear-nose-throat (ENT) departments in the Region of Southern Denmark from January 2017 to December 2021. Patients with the International Classification of Diseases, tenth version (ICD-10) codes related to tonsillectomy (emb 10, -15, -20, and -99) combined with the post-operative haemorrhage ICD-10 (DT810) were included in the study. The exclusion criteria were haemorrhage other than PTH and misclassification. The exact time and date for hospital arrival were assigned in three-hour slots. The primary outcome was diurnal variation. Secondary outcomes included the severity of PTH, among other demographic variations. The data were evaluated by a χ2 test.

Results: A total of 459 contacts were analysed, corresponding to a PTH contact rate of 8%. Hereof, 382 events had active PTH (6.7%). When only secondary PTH (n = 375) were considered, the diurnal PTH contacts fluctuated significantly; nocturnal events (9 PM-9 AM) accounted for 233 hospital contacts (62%).

Conclusions: We found that PTH contacts were more frequent at nighttime, highlighting the need for vigilance to optimise healthcare resources and patient safety. Further research on PTH aetiology is needed.

Funding: None.

Trial registration: Not relevant.