Investigation of Adult Post‐Tonsillectomy Hemorrhage Rates and the Impact of NSAID Use

Abstract

Objectives/Hypothesis Tonsillectomy is one of the most common ambulatory surgeries performed in the United States, yet the incidence of post‐tonsillectomy hemorrhage (PTH) in adults remains unclear. In addition, any association between non‐steroidal anti‐inflammatory drugs (NSAIDs) and PTH in adults is currently unknown. The aim of this study is to examine the incidence and management of adult PTH at a single academic center and to assess for any association between NSAID use and PTH in adults. Study Design Retrospective chart review. Methods We conducted a retrospective chart review of adult tonsillectomies performed at our institution between January 1, 2012, and December 30, 2019. Demographics, past medical history, medications, NSAID use, surgical indication, bleeding events, and interventions were documented. The rate of PTH was calculated, logistic regression was performed to assess for any predictive factors, and odds ratios were calculated for NSAID use and PTH. Results A total of 1,057 adult tonsillectomies were performed within the aforementioned time period. A total of 126 patients experienced 163 bleeding events for a postoperative hemorrhage rate of 11.9%. Most were controlled with bedside interventions, while 29 (23%) bled more than once. The hemorrhage rate for those who were not prescribed NSAIDs postoperatively (n = 625) was 11.7%, compared to 12.6% for those who did receive NSAIDs postoperatively (n = 432), which was not significantly different (adjusted odds ratio 1.01, 95% confidence interval 0.69–1.49; P = .95). Conclusions This retrospective cohort study of 1,057 adult patients found the incidence of PTH to be 11.9%. This study found no association between the use of NSAIDs and the rate of PTH, although a higher‐powered study is needed. Level of Evidence 3 Laryngoscope , 132:949–953, 2022