ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2020
Regional variability of hemorrhage following tonsil surgery in 1,520,234 cases.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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- Tonsillectomy compared with conservative management in patients over 16 years with recurrent sore throat: the NATTINA RCT and economic evaluation.Health technology assessment (Winchester, England) · 2023Trial
- Head-to-head comparison of [Cancer imaging : the official publication of the International Cancer Imaging Society · 2024Article
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3 authors at 2 institutions in 2 countries.
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Abstract
purposeTo evaluate, whether the regional variability of tonsil surgery in terms of the 16 Federal States of Germany was mirrored by a comparable variability of bleeding complications in male and female patients.
methodsA longitudinal population-based inpatient cohort study was performed including all patients who had undergone tonsil surgery between 2005 and 2018. The database was provided by the Federal Statistical Office of Germany and included all inpatient cases after tonsillectomy (with or without adenoidectomy), tonsillotomy, abscess-tonsillectomy and secondary tonsillectomy. The population was stratified by region (16 Federal States) and gender. Operation rates were calculated in relation to the end-year population number of each region. Bleeding percentages were calculated for each calendar year and region as the number of procedures to achieve hemostasis divided by the total number of operations.
resultsThe surgical rates varied significantly between the 16 Federal States in male, female and all patients (p = 0.001). Revision surgery to achieve hemostasis was predominantly performed in male patients (5.2-11.4% male vs. 3.7-7.6% female patients). Bleeding percentages did not differ significantly from national values in male and female patients in 5 Federal States, but were significantly higher than the national average in 3 Federal States and significantly lower in 7 Federal States for both genders (p < 0.05), while in 1 Federal State it was significantly lower only for the male patients. Pearson's correlation coefficient for surgical and bleeding rates was positive and statistically significant (p < 0.05) for all Federal States, except for two. This phenomenon was emphasized by female gender.
conclusionsGender had an impact not only on surgical rates but also on bleeding percentages and this was independent from the decrease in the total number of operations. Surprisingly, there was a clear correlation between the rates of both variables in the majority of the Federal States of Germany. It needs further studies to clarify, why a higher prevalence of surgical practice, thus surgical experience, was not followed by lower bleeding complications.
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