PMID- 22522935
OWN - NLM
STAT- MEDLINE
DCOM- 20120817
LR  - 20161125
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 122
IP  - 6
DP  - 2012 Jun
TI  - Postoperative hemorrhage following adenoidectomy.
PG  - 1246-53
LID - 10.1002/lary.23279 [doi]
AB  - OBJECTIVES/HYPOTHESIS: To examine postoperative hemorrhage following 
      adenoidectomy. STUDY DESIGN: Prospective multicenter observational study. 
      METHODS: The Surgical Instrument Surveillance Programme (SISP) was established in 
      2003 to monitor tonsil and adenoid surgery in all hospitals in Wales. Data were 
      examined between April 1, 2003 and June 30, 2008, for risk factors that may 
      contribute to primary (R1) or secondary (R2) postoperative hemorrhage from the 
      adenoid bed, of a severity sufficient to require a return to the operating room. 
      RESULTS: There were 5,588 procedures included, of which 4,225 included 
      simultaneous tonsillectomy. The study included 2,903 (52%) males with a median 
      age of 5.8 years (interquartile range [IQR], 4.5-7.7 years) and 2,685 (48%) 
      females with a median age of 6.5 years (IQR, 5.0-9.1 years). There were 22 
      patients (0.4%; confidence interval [CI], 0.2-0.6) who returned to the operating 
      room with a postoperative hemorrhage arising from the adenoid bed. These were 
      exclusively R1 hemorrhage; there were no instances of R2 hemorrhage (0.0%; CI, 
      0.0-0.1). No specific risk factors for R1 hemorrhage could be identified. There 
      were 38 patients in the adenotonsillectomy group who returned to operating room 
      with a postoperative hemorrhage arising from the tonsil bed (0.5%; CI, 0.3-0.8). 
      R1 was seen in 22 patients (0.5%; CI, 0.3-0.8) and R2 in 16 patients (0.4%; CI, 
      0.2-0.6). CONCLUSIONS: Adenoidectomy appears to be primarily a procedure 
      performed in childhood. The rate of R1 hemorrhage following adenoidectomy is one 
      in 200 (0.5%) and is similar to the R1 hemorrhage rate for tonsillectomy. R2 
      hemorrhage following an adenoidectomy appears to be extremely rare. In children, 
      the risk of a serious primary hemorrhage following an adenotonsillectomy is 
      double that of either procedure when performed alone.
CI  - Copyright (c) 2012 The American Laryngological, Rhinological, and Otological 
      Society, Inc.
FAU - Tomkinson, Alun
AU  - Tomkinson A
AD  - Department of Otolaryngology-Head and Neck Surgery, University Hospital Wales, 
      Cardiff, United Kingdom. tomkinsona@cardiff.ac.uk
FAU - Harrison, Wendy
AU  - Harrison W
FAU - Owens, David
AU  - Owens D
FAU - Fishpool, Samuel
AU  - Fishpool S
FAU - Temple, Mark
AU  - Temple M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20120420
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Adenoidectomy/*adverse effects/methods/statistics & numerical data
MH  - Age Distribution
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Confidence Intervals
MH  - Databases, Factual
MH  - Female
MH  - Follow-Up Studies
MH  - *Hemostatic Techniques
MH  - Humans
MH  - Incidence
MH  - Logistic Models
MH  - Male
MH  - Odds Ratio
MH  - Postoperative Hemorrhage/diagnosis/*epidemiology/therapy
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Sex Distribution
MH  - Tonsillectomy/*adverse effects/methods/statistics & numerical data
MH  - Treatment Outcome
MH  - United Kingdom
EDAT- 2012/04/24 06:00
MHDA- 2012/08/18 06:00
CRDT- 2012/04/24 06:00
PHST- 2011/09/26 00:00 [received]
PHST- 2012/02/08 00:00 [revised]
PHST- 2012/02/10 00:00 [accepted]
PHST- 2012/04/24 06:00 [entrez]
PHST- 2012/04/24 06:00 [pubmed]
PHST- 2012/08/18 06:00 [medline]
AID - 10.1002/lary.23279 [doi]
PST - ppublish
SO  - Laryngoscope. 2012 Jun;122(6):1246-53. doi: 10.1002/lary.23279. Epub 2012 Apr 20.