Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-19T14:09:16.493Z Has data issue: false hasContentIssue false
  • English
  • Français

Is weekend surgery a risk factor for post-tonsillectomy haemorrhage?

Published online by Cambridge University Press:  13 June 2016

A Patel ,
N Foden  and
A Rachmanidou
A Patel*
Affiliation:
ENT Department, University Hospital Lewisham, UK
N Foden
Affiliation:
ENT Department, University Hospital Lewisham, UK
A Rachmanidou
Affiliation:
ENT Department, University Hospital Lewisham, UK
*
Address for correspondence: Mr A Patel, 9 Elstree Hill, Bromley BR1 4JE, UK Fax: 020 8333 333 E-mail: ankitpatel@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Tonsillectomy is a common, low-risk procedure. Post-tonsillectomy haemorrhage remains the most serious complication. Recent nationwide studies in the UK have identified an increased morbidity and mortality for both high-risk and low-risk elective general surgery performed at the weekend.

Methods:

Data for tonsillectomies performed at a district general hospital over a three-year period were retrospectively reviewed. The same group of surgeons performed elective tonsillectomies on both weekends and weekdays. All patients who developed a post-tonsillectomy haemorrhage were identified and the day of original operation was noted.

Results:

Between 2010 and 2013, 2208 (94.00 per cent) elective tonsillectomies were performed on a weekday and 141 (6.00 per cent) were performed on the weekend. Post-tonsillectomy haemorrhages occurred in 104 patients (4.71 per cent) who underwent their procedure on a weekday and in 10 patients (7.09 per cent) who had their surgery at the weekend (p = 0.20).

Conclusion:

There is no difference in the rate of post-tonsillectomy haemorrhage for procedures performed on a weekday or weekend.

Keywords

TonsillectomyPostoperative HemorrhageElective Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 8 , August 2016 , pp. 763 - 767
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the 16th Association of Southeast Asian Nations (‘ASEAN’) Otolaryngology – Head Neck Surgery Congress, 11–13 November 2015, Chiang Mai, Thailand, and at the Society of Academic and Research Surgery, 6–7 January 2016, London, UK.

References

1 Brown, P, Ryan, R, Yung, M, Browne, J, Copley, L, Cromwell, D et al. National Prospective Tonsillectomy Audit. London: Royal College of Surgeons of England, 2005 Google Scholar
2 Stuck, B, Gotte, K, Windfuhr, FJ, Genzwurker, H, Schroten, H, Tenenbaum, T. Tonsillectomy in children. Dtsch Arztebl Int 2008;105:852–61Google Scholar
3 Konieczny, K, Biggs, T, Caldera, S. Application of the Paediatric Throat Disorders Outcome Test (T-14) for tonsillectomy and adenotonsillectomy. Ann R Coll Surg Engl 2013;95:410–14Google Scholar
4 Ostvoll, E, Sunnergren, O, Ericsson, E, Hemlin, C, Hultcrantz, E, Odhagen, E et al. Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden. Eur Arch Otorhinolaryngol 2015;272:737–43Google Scholar
5 Windfuhr, JP, Verspohl, BC, Chen, YS, Dahm, JD, Werner, JA. Post-tonsillectomy haemorrhage–some facts will never change. Eur Arch Otorhinolaryngol 2015;272:1211–18CrossRefGoogle ScholarPubMed
6 Burton, MJ, Doree, C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 2007;(3):CD004619 Google Scholar
7 Mosges, R, Hellmich, M, Allekotte, S, Albrecht, K, Bohm, M. Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials. Eur Arch Otorhinolaryngol 2011;268:807–16Google Scholar
8 Koscielny, J, Ziemer, S, Radtke, H, Schmutzler, M, Pruss, A, Sinha, P et al. A practical concept for preoperative identification of patients with impaired primary haemostasis. Clin Appl Thromb Hemost 2004;10:195–204 Google Scholar
9 Aylin, P, Yunus, A, Bottle, A, Majeed, A, Bell, D. Weekend mortality for emergency admissions. A large, multicentre study. Qual Saf Health Care 2010;19:213–17Google Scholar
10 Aylin, P, Alexandrescu, R, Jen, MH, Mayer, EK, Bottle, A. Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics. BMJ 2013;346:f2424 Google Scholar
11 Mohammed, MA, Sidhu, KS, Rudge, G, Stevens, AJ. Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: a retrospective database study of National Health Service hospitals in England. BMC Health Serv Res 2012;12:87 Google Scholar
12 Becker, DJ. Do hospitals provide lower quality care on weekends? Health Serv Res 2007;42:1589–612Google Scholar
13 Fonarow, GC, Abraham, WT, Albert, NM, Stough, WG, Gheorghiade, M, Greenberg, BH et al. Day of admission and clinical outcomes for patients hospitalized for heart failure: findings from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF). Circ Heart Fail 2008;1:50–7Google Scholar
14 Roberts, S, Thorne, K, Akbari, A, Samuel, DJ, Williams, JG. Weekend emergency admissions and mortality in England and Wales. Lancet 2015;385:1829 CrossRefGoogle ScholarPubMed
15 Audit Commission. Operating Theatres – Review of National Findings. London: Audit Commission, 2003 Google Scholar