Gender-specific risk factors in post-tonsillectomy hemorrhage

• Published in: European archives of oto-rhino-laryngology 2016-12, Vol.273 (12), p.4535-4541
• Main Authors: Coordes, Annekatrin, Soudry, Janina, Hofmann, Veit Maria, Lenarz, Minoo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Alcohol Drinking - adverse effects; Berlin; Child; Child, Preschool; Female; Glucocorticoids - adverse effects; Head and Neck; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Neurosurgery; Otorhinolaryngology; Postoperative Hemorrhage - etiology; Retrospective Studies; Risk Factors; Sex Factors; Smoking - adverse effects; Surveys and Questionnaires; Tonsillectomy - adverse effects
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-016-4146-7

There are gender-specific differences in the frequency and course of different diseases. Specifically, some studies have shown an increased risk of post-tonsillectomy hemorrhage (PTH). The aim of the study was to investigate gender-specific risk factors for hemorrhage after tonsillectomy (TE)/abscess-TE. We anonymously reviewed and recorded the relevant data of all patients (≥14 years) who underwent a TE/abscess-TE between 2011 and 2013 in the ENT Clinic of the Charité Universitätsmedizin Berlin, Campus Benjamin Franklin. A patient survey was used to complete missing data. We analyzed gender-specific risk factors for PTH. During the study period, 460 operations were performed and the data of 250 patients were analyzed (213 TE and 37 abscess-TE). The median patient age was 27 years (ranging from 14 to 83 years). The rate of primary PTH (24 h) was 23 %. A significantly higher PTH rate was associated with males ( p  = 0.037), which was still apparent in ages 21–30 after sub-classification. Multivariate analysis calculated diagnosis, regular alcohol consumption and administration of glucocorticoids to be independent risk factors associated with gender. In conclusion, the PTH rate is gender-specific, and male patients are at higher risk, especially in young adulthood. Therefore, doctors should advise male patients of the increased risk of bleeding and stress the importance of compliance. Also, close postoperative follow-up is desirable.