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Taylor M. Study of Patients’ Return to Surgery Post-Tonsillectomy and/or Adenoidectomy: A Relation Between Patient Age and Timing of Uncontrolled Bleeding. PATIENT SAFETY 2022. [DOI: 10.33940/data/2022.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Tonsillectomy and/or adenoidectomy (T/A) are common surgical procedures. Postoperative uncontrolled bleeding is a well-established complication; however, the relation between certain variables and uncontrolled bleeding are unclear.
Methods: We explored the Pennsylvania Patient Safety Reporting System database for event reports that described a patient who had a T/A procedure and later returned to surgery to control bleeding. We analyzed the post-T/A bleeding events according to numerous variables, such as patient sex and age, timing of the bleed, procedure performed (i.e., tonsillectomy and/or adenoidectomy), and bleeding site.
Results: We identified 219 event reports from 56 healthcare facilities over a four-year period. The study revealed that 78% of the patients were discharged and then returned to surgery to control bleeding. Patients ranged in age from 1–45 years and 53% were female. Among the 219 events, 41% were a primary bleed (0–1 postoperative days) and 59% were a secondary bleed (2–30 postoperative day). Additionally, 0–1 days and 6–7 days after operation were the periods when patients most frequently returned to surgery (range of 0–30 days). We expanded upon much of the previous research by exploring the relation between patient age and days postoperative return to surgery. We found that a majority of patients in age categories 1–10, 11–20, and 21–30 years had a secondary bleed; in contrast, a majority of patients age 31–45 had a primary bleed.
Conclusion: Our findings indicate that the post-T/A timing of uncontrolled bleeding may vary systematically as a function of patient age; however, future research is needed to better understand this topic. We encourage readers to use our findings, along with findings from previous research, to inform their practice and strategies to mitigate risk of patient harm.
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Safety of outpatient admission and comparison of different surgical techniques in adult tonsillectomy. Eur Arch Otorhinolaryngol 2019; 276:1211-1219. [DOI: 10.1007/s00405-019-05334-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
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Camacho M, Li D, Kawai M, Zaghi S, Teixeira J, Senchak AJ, Brietzke SE, Frasier S, Certal V. Tonsillectomy for adult obstructive sleep apnea: A systematic review and meta-analysis. Laryngoscope 2016; 126:2176-86. [DOI: 10.1002/lary.25931] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/13/2015] [Accepted: 01/29/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Macario Camacho
- Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine; Tripler Army Medical Center; Honolulu Hawaii
- Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division; Stanford Hospital and Clinics; Stanford California
| | - Dongcai Li
- Shenzhen Key Laboratory of ENT, Institute of ENT & Longgang ENT hospital; Shenzhen, China; Stanford California
| | - Makoto Kawai
- Department of Psychiatry and Behavioral Sciences; Stanford University, School of Medicine; Stanford California
- Sierra Pacific Mental Illness Research Education and Clinical Centers; VA Palo Alto Health Care System; Palo Alto California
| | - Soroush Zaghi
- Department of Head and Neck Surgery; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Jeffrey Teixeira
- Department of Otolaryngology-Head and Neck Surgery; Walter Reed National Military Medical Center; Bethesda Maryland
| | - Andrew J. Senchak
- Department of Otolaryngology-Head and Neck Surgery; Walter Reed National Military Medical Center; Bethesda Maryland
| | - Scott E. Brietzke
- Department of Otolaryngology-Head and Neck Surgery; Walter Reed National Military Medical Center; Bethesda Maryland
| | - Samuel Frasier
- Department of Otolaryngology-Head and Neck Surgery; Naval Medical Center Portsmouth; Portsmouth Virginia USA
| | - Victor Certal
- Department of Otorhinolaryngology/Sleep Medicine Centre-Hospital CUF & CHEDV Porto; University of Porto; Porto Portugal
- CINTESIS-Center for Research in Health Technologies and Information Systems; University of Porto; Porto Portugal
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Ahmad R, Abdullah K, Amin Z, Rahman JA. Predicting safe tonsillectomy for ambulatory surgery. Auris Nasus Larynx 2010; 37:185-9. [DOI: 10.1016/j.anl.2009.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 05/25/2009] [Accepted: 06/30/2009] [Indexed: 11/29/2022]
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