caa a22 4500 606184201 CHVBK 20210128100825.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00405-014-3431-6 doi (NATIONALLICENCE)springer-10.1007/s00405-014-3431-6 Population-based analysis of tonsil surgery and postoperative hemorrhage [Elektronische Daten] [J. Mueller, D. Boeger, J. Buentzel, D. Esser, K. Hoffmann, P. Jecker, A. Mueller, G. Radtke, K. Geißler, T. Bitter, O. Guntinas-Lichius] Although tonsil surgery is one of the most frequent otorhinolaryngological procedures, not many population-based regional or country-wide studies are published on the incidence of postoperative bleeding and its risk factors. 2,216 patients underwent tonsil surgery in 2012 in Thuringia, a federal state in Germany. Most frequent indications were recurrent tonsillitis (44% of all cases), tonsillar abscess (27%), and tonsillar hyperplasia (20%). 29% of the patients were <10years of age. Most frequent methods of surgery were tonsillectomy (73%) and tonsillotomy (19%). 215 patients (10%) had 221 events of a postoperative hemorrhage. Re-surgery for hemostasis was necessary in 137 patients (6%). The interval to re-surgery was 4.4±4.6days. The re-surgery rate was 8, 0.2, and 15% after tonsillectomy, tonsillotomy, and radical tonsillectomy, respectively. In cases of recurrent tonsillitis, male gender (p<0.001), age >24.78years (median; (p=0.018), and waiving of perioperative antibiotics (p=0.029) were independent factors associated with hemorrhage. In cases of tonsillar hyperplasia tonsillectomy instead of tonsillotomy, the only significant risk factor was postoperative hemorrhage (p=0.005). The overall incidence of tonsillar surgery was 87.6/100,000. The highest incidence was seen for patients 3-4years of age with 862.7/100,000. In children <10years, the incidence was always higher for boys than for girls. Throughout all age groups, a reverse gender relation was only seen, if surgery was indicated for recurrent tonsillitis. We recommend establishing national guidelines for indication of tonsil surgery, especially of tonsillectomy, including recommendations for perioperative care to decrease variations in tonsil surgery rates and minimize postoperative complications. Springer-Verlag Berlin Heidelberg, 2014 Tonsil nationallicence Surgery nationallicence Complication nationallicence Outcome nationallicence Epidemiology nationallicence Health services research nationallicence Bleeding nationallicence Mueller J. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut Boeger D. Department of Otorhinolaryngology, Zentralklinikum, Suhl, Germany aut Buentzel J. Department of Otorhinolaryngology, Südharz-Krankenhaus gGmbH, Nordhausen, Germany aut Esser D. Department of Otorhinolaryngology, Helios-Klinikum, Erfurt, Germany aut Hoffmann K. Department of Otorhinolaryngology, Sophien/Hufeland-Klinikum, Weimar, Germany aut Jecker P. Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany aut Mueller A. Department of Otorhinolaryngology, SRH Wald-Klinikum, Gera, Germany aut Radtke G. Department of Otorhinolaryngology, Ilm-Kreis-Kliniken, Arnstadt, Germany aut Geißler K. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut Bitter T. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut Guntinas-Lichius O. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/12(2015-12-01), 3769-3777 0937-4477 272:12<3769 2015 272 405 https://doi.org/10.1007/s00405-014-3431-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3431-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mueller J. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut NATIONALLICENCE 700 1- Boeger D. Department of Otorhinolaryngology, Zentralklinikum, Suhl, Germany aut NATIONALLICENCE 700 1- Buentzel J. Department of Otorhinolaryngology, Südharz-Krankenhaus gGmbH, Nordhausen, Germany aut NATIONALLICENCE 700 1- Esser D. Department of Otorhinolaryngology, Helios-Klinikum, Erfurt, Germany aut NATIONALLICENCE 700 1- Hoffmann K. Department of Otorhinolaryngology, Sophien/Hufeland-Klinikum, Weimar, Germany aut NATIONALLICENCE 700 1- Jecker P. Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany aut NATIONALLICENCE 700 1- Mueller A. Department of Otorhinolaryngology, SRH Wald-Klinikum, Gera, Germany aut NATIONALLICENCE 700 1- Radtke G. Department of Otorhinolaryngology, Ilm-Kreis-Kliniken, Arnstadt, Germany aut NATIONALLICENCE 700 1- Geißler K. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut NATIONALLICENCE 700 1- Bitter T. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut NATIONALLICENCE 700 1- Guntinas-Lichius O. Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/12(2015-12-01), 3769-3777 0937-4477 272:12<3769 2015 272 405