title: Reduced risk of primary postoperative hemorrhage after tonsil surgery in Sweden: results from the National Tonsil Surgery Register in Sweden covering more than 10 years and 54,696 operations.
abstract: OBJECTIVE
  To analyze the incidence of primary bleeding following tonsil surgery and to evaluate risk factors.
  
  
  METHODS
  Register study of the results from the National Tonsil Surgery Register in Sweden covering the period 1997 to 2008 and 54,696 operations.
  
  
  METHODS
  Data were collected by means of three questionnaires, two filled in by professionals and one 6 months postoperatively by the patient/parent.
  
  
  RESULTS
  A total of 719 patients experienced primary postoperative bleeding during the hospital stay (1.3%). A number of independent factors were correlated with decreased risk of post-tonsillectomy hemorrhage: younger age (P < .0001), female sex (P < .0001), type of surgery (tonsillotomy) (P = .0006), and surgery performed on a day-surgery basis (P < .0001). Indication for surgery and number of operations performed at the department did not correlate with postoperative bleeding risk. A significant decrease in primary postoperative hemorrhage rate from 2% to 0.96% was found during the study period.
  
  
  CONCLUSIONS
  Primary hemorrhage following tonsil surgery is rare. During the study period, a significant decrease in primary bleeding rates occurred. The changes in practice with an increasing proportion of day-surgery cases and tonsillotomy have contributed to the reduced risk, but cannot completely explain the reduction.
authors: Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden. anne-charlotte.hessen-soderman@karolinska.se
authors: Anne-Charlotte
authors: AC
authors: Hessén Söderman
authors: Elisabeth
authors: E
authors: Ericsson
authors: Claes
authors: C
authors: Hemlin
authors: Elisabeth
authors: E
authors: Hultcrantz
authors: Ingemar
authors: I
authors: Månsson
authors: Kristian
authors: K
authors: Roos
authors: Joacim
authors: J
authors: Stalfors
mesh_terms: D000233:Adenoidectomy / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014066:Palatine Tonsil / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D012042:Registries; D012307:Risk Factors; D013548:Sweden; D014068:Tonsillectomy / Q000706:statistics & numerical data*; D055815:Young Adult