title: A telephone audit in parallel with the UK national tonsillectomy audit to investigate re-admission as a measure of secondary haemorrhage rate.
abstract: OBJECTIVE
  An audit to run in parallel with the remaining 5 months (at the time of conception) of the national tonsillectomy audit to examine the accuracy of re-admission following bleeding as a measure of secondary haemorrhage rate.
  
  
  METHODS
  A retrospective, case series audit of all patients undergoing tonsillectomy between 29th April and 1st October 2004 at Frimley Park Hospital a UK District General Hospital. One hundred and twenty-nine patients (adults and children) undergoing tonsillectomy were contacted by telephone 2 weeks after surgery. The main outcome measures were reported bleeding and re-admission. We reviewed all studies reported in the literature investigating secondary haemorrhage rate in the community.
  
  
  RESULTS
  This study demonstrated 19% (n=24) of patients experienced bleeding post-operatively. Ten per cent (n=13) returned to hospital for advice and were admitted. The literature review shows the variability of the proportion of patients with bleeding that are re-admitted is 33.3 standard deviations.
  
  
  CONCLUSIONS
  There are widely different regional re-admission rates for post-tonsillectomy secondary haemorrhage. Re-admission is an unreliable measure of secondary haemorrhage. Change of practise based on conclusions drawn from re-admission rates are unsound.
authors.affiliation: Department of Ear Nose and Throat Surgery, Frimley Park Hospital, Surrey GU16 7UJ, UK. bertieharris@yahoo.com
authors.forename: Robert L
authors.initials: RL
authors.lastname: Harris
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: David A
authors.initials: DA
authors.lastname: Jonathan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D010359:Patient Readmission; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012008:Recurrence; D012189:Retrospective Studies; D013689:Telephone; D014068:Tonsillectomy; D006113:United Kingdom