Assessing the effect of a standardized family history bleeding questionnaire on tonsillectomy outcomes in pediatric patients

Objectives

The use of standardized questionnaires has been suggested as a technique to predict preoperative risk and reduce the incidence of post-tonsillectomy bleeding (PTB). This study assesses the association between the administration of a validated questionnaire regarding family history of various bleeding events and the rate of PTB, preoperative hematology referral, and bleeding disorder diagnoses.

Methods

A retrospective cohort study involving pediatric patients who underwent palatine tonsillectomy between January 1, 2014 and December 31, 2019, was conducted. Patients who had not been administered the standardized bleeding questionnaire were assigned to the pre-standardization cohort. Those who had been administered the standardized questionnaire made up the post-standardization cohort. Rates of PTB, preoperative hematology referral, and bleeding disorder diagnoses were compared between the cohorts.

Results

Following screening, 1477 patients were included with 1043 assigned to the pre-standardization cohort and 434 to the post-standardization cohort. PTB requiring operative intervention occurred at a rate of 3 % and 2 % in the pre- and post-standardization groups, respectively. Administration of the standardized questionnaire was associated with a 2.46 times greater rate of hematology referral compared to the pre-standardization cohort (95 % CI: 1.47 to 4.14). The rate of bleeding disorder diagnoses was not significantly different between the cohorts.

Conclusions

The use of a standardized questionnaire was not associated with a reduced rate of PTB. Administration of the questionnaire led to an increase in preoperative hematology referrals without an increased rate of bleeding disorder diagnoses. Further clinical investigation of PTB risk prediction and reduction strategies is necessary to optimize tonsillectomy outcomes.