title: [Tonsillectomy in adults: Length of hospital stay has no influence on the frequency of postoperative hemorrhage].
abstract: BACKGROUND
  Tonsillectomies (TE) in Germany are traditionally performed during inpatient hospital stays. Socioeconomic changes in the healthcare system have resulted in shorter hospital stays.
  
  
  OBJECTIVE
  The aim of the study was to investigate whether a shorter hospital stay of 2 days leads to increased postoperative bleeding after TE. Factors affecting the duration of hospitalization were also studied.
  
  
  METHODS
  The relevant data of all patients (≥ 14 years) undergoing TE in the ENT Clinic of the Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, between 2011 and 2013 were recorded anonymously. Risk factors for bleeding after TE were analyzed. Additionally, patients who had a hospital stay of 2 days (since 2013) were compared with patients hospitalized for ≥ 3 days, and the influence of various risk factors on the length of hospital stay was analyzed.
  
  
  RESULTS
  During the study period 2011-2013, 376 procedures were performed and data from 213 patients was collected for analysis. Median patient age was 26 years (range 14-73 years). The rate of primary hemorrhage (up to 24 hours after TE) was 2% and the rate of secondary bleeding (later than 24 hours) was 24%. In 7% of patients with postoperative haemorrhage (primary and secondary) surgical hemostasis was performed. Male gender was associated with a significantly higher haemorrhage rate. Shortening postdischarge surveillance to only 2 days did not affect the postoperative bleeding rate.
  
  
  CONCLUSIONS
  The duration of stationary monitoring following TE should not only be based on the rate of secondary bleeding, but also on patient comfort and safety. A shortening of postoperative monitoring to only 2 days had no effect on the haemorrhage frequency after TE and can therefore, be considered for adults who do not live alone and are within a reasonable distance to a hospital.
authors.affiliation: Campus Benjamin Franklin, HNO-Klinik der Charité, Hindenburgdamm 30, 12200, Berlin, Deutschland. annekatrin.coordes@charite.de.
authors.forename: A
authors.initials: A
authors.lastname: Coordes
authors.affiliation: Campus Benjamin Franklin, HNO-Klinik der Charité, Hindenburgdamm 30, 12200, Berlin, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Soudry
authors.affiliation: Campus Benjamin Franklin, HNO-Klinik der Charité, Hindenburgdamm 30, 12200, Berlin, Deutschland.
authors.forename: V M
authors.initials: VM
authors.lastname: Hofmann
authors.affiliation: Campus Benjamin Franklin, HNO-Klinik der Charité, Hindenburgdamm 30, 12200, Berlin, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Lenarz
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000706:statistics & numerical data*; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014068:Tonsillectomy / Q000706:statistics & numerical data*; D014069:Tonsillitis / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Antibiotics; Gender; Length of stay; Postoperative hemorrhage; Tonsillectomy