A Study on Risk Factors for Postoperative Hemorrhage After 164 Cases of Tonsillectomy

Tonsillectomy is one of the most frequently performed surgical procedures in the field of otorhinolaryngology and is one of the first procedures that otorhinolaryngologists learn. Of the surgical complications, postoperative hemorrhage requires special attention because of the associated risk of airway obstruction. We investigated the risk factors for postoperative bleeding in patients who underwent tonsillectomy at our hospital. A total of 164 patients who underwent palatoglossus tonsillectomy at our hospital during the 5-year period between January 2018 and December 2022 were included in the study. Postoperative bleeding was defined as bleeding from the surgical wound or the presence of a clot in the surgical wound at the time of examination. The patient’s sex and age, indications for surgery, presence/absence of underlying hypertension and diabetes mellitus, body mass index (BMI), use of antithrombotic drugs, smoking status, and years of experience of the surgeon were extracted from medical records, and the patients were divided into two groups: the postoperative bleeding group and the non-postoperative bleeding group. After variable selection using the χ-square test and stepwise elimination method, multivariate logistic regression analysis was performed. The χ-square test showed a significant difference for habitual tonsillitis, and multivariate analysis showed that only habitual tonsillitis was selected (odds ratio = 7.27, P < 0.001). Although not statistically significant, there was a trend toward a higher risk of postoperative bleeding in males (odds ratio = 2.30, P = 0.062). Habitual tonsillitis was identified as a risk factor for postoperative hemorrhage, with a trend toward a higher risk of postoperative hemorrhage in men. Habitual tonsillitis is thought to increase the risk of postoperative bleeding because repeated inflammation causes adhesions to the surrounding tissues and neovascular vessel formation.