Post-Tonsillectomy Hemorrhage: An Analysis of Incidence and Risk Factors in Kuwait

Introduction: Post-Tonsillectomy Hemorrhage (PTH) remains one of the commonest complications associated with tonsillectomies. Its incidence and risk factors vary widely in literature. Objective: To examine our local experience and assess the incidence of PTH in comparison to that in the literature and to identify factors that contribute in increasing the risk of PTH in our setup. Design: Retrospective study Setting: Al-Sabah and Zain Hospital, MoH, Kuwait Methods: A retrospective chart review was conducted on 2,038 patients who underwent tonsillectomy with or without adenoidectomy during a 12-month period (January to December 2010) in Zain and Al Sabah hospitals. Details regarding the patients' age, gender, surgical technique, and level of the operating surgeon were recorded in order to assess any correlation. Intervention: Tonsillectomy Main Outcome Measure: Incidence of PTH Results: Out of the 2,038 patients included in this study, a total of 98 patients (4.8%) developed PTH. Thirty-one patients (31.6%) who developed PTH were above the age of 26 years. Out of the 98 patients (4.8%) who developed PTH, 63 patients (64.3%) were male. 'Hot' dissection technique was associated with higher incidence of PTH (71 patients; 72.4%) in comparison to the 'cold' dissection (27 patients; 27.5%). Conclusion: The incidence of PTH in our institution is 4.8%, which is comparable with that reported in the literature, ranging between 1.5% and 6.68%. Male patients, increasing age and 'Hot' dissection technique were all identified as risk factors for PTH in our setup.