Publication:

Incidence and patterns of post-tonsillectomy hemorrhage in paediatric patients: a hospital-based study

Background Post-tonsillectomy hemorrhage (PTH) is a potentially serious complication in pediatric patients, contributing to increased morbidity, hospital readmission, and healthcare burden. Its incidence and clinical patterns vary depending on multiple patient- and procedure-related factors, particularly in developing healthcare settings. The aim of the study was to determine the incidence and patterns of PTH in pediatric patients and evaluate associated risk factors, timing, severity, and management outcomes.

Methods This hospital-based observational study was conducted over 1 year in a tertiary care hospital in Bangladesh, including 220 pediatric patients who underwent tonsillectomy. Data were collected using a structured format covering demographic variables, type and timing of hemorrhage, severity, clinical presentation, management strategies, and associated risk factors. Statistical analysis was performed using statistical package for the social sciences (SPSS) version 26, with results expressed as frequency and percentage. A p≤0.05 was considered statistically significant.

Result The mean age of patients was 8.6±3.2 years, with a male predominance (60.00%). Secondary hemorrhage (90.91%) was more common than primary hemorrhage (9.09%), most frequently occurring on days 5-10 (58.00%). Mild hemorrhage accounted for 46.36% of cases, while 10.91% required surgical intervention. Oral bleeding was present in 100.00% of patients, followed by blood-stained saliva (71.82%) and hematemesis (25.45%). Conservative management was sufficient in 46.36% of cases, whereas 12.73% required blood transfusion. Major associated risk factors included Diathermy technique (45.45%), infection (40.00%), and dehydration (32.73%).

Conclusion Post-tonsillectomy hemorrhage is predominantly secondary in nature, with identifiable risk factors and varied clinical severity. Early recognition, improved surgical techniques, and effective postoperative care are essential to minimize complications and enhance pediatric patient outcomes.