ArticleTurkish archives of otorhinolaryngology2026
Risk Factors for Post-Tonsillectomy Hemorrhage: A 10-Year Retrospective Cohort Study at a Tertiary Military Hospital in Thailand.
Article in Turkish archives of otorhinolaryngology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Tonsillectomy is one of the most frequently performed surgical procedures worldwide, and several patient-and procedure-related factors have been associated with post-tonsillectomy hemorrhage (PTH). Severe hemorrhage may require reoperation under general anesthesia to achieve hemostasis. The aim of this retrospective cohort study was to identify pre-, intra-, and postoperative factors associated with PTH. Methods: Records of 549 patients who underwent tonsillectomy at a tertiary military hospital in Thailand between 2010 and 2020 were reviewed, with PTH ascertained by detailed manual chart review. Results: The mean age was 26.89±15.69 years. PTH occurred in 56 patients (10.2%), most commonly on postoperative day 6. Multivariate logistic regression identified the following independent risk factors: male sex [p=0.039; adjusted odds ratio (aOR) 2.11, 95% confidence interval (CI) 1.04-4.30], age<19 years (p=0.016; aOR 7.96, 95% CI 1.46-43.27), age 19-45 years (p=0.024; aOR 5.74, 95% CI 1.26-26.11), surgeon experience <15 years (p=0.023; aOR 2.85, 95% CI 1.16-7.01), elevated mean arterial pressure (MAP) (p=0.002; aOR 1.04 per mmHg, 95% CI 1.02-1.07), intravenous (IV) antibiotic prescription (p=0.036; aOR 2.03, 95% CI 1.05-3.92), and a day-1 pain score >5 (p=0.037; aOR 2.25, 95% CI 1.05-4.81). As the >45-year reference group had few events, the age odds ratios were imprecise; a Firth-penalized pediatric estimate was 6.33 (95% CI 1.52-37.37), and a pooled age <45 versus ≥45 contrast gave aOR 5.07 (95% CI 1.56-26.00). Conclusion: Male sex, age under 45 years, and surgeon experience less than 15 years were the principal independent predictors of PTH; elevated postoperative MAP, a day-1 pain score above 5, and IV antibiotic prescription further characterized higher-risk patients.
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