Abstract
Objectives
To identify the risk factors for post-tonsillectomy hemorrhage (PTH) in adult patients
(>19 years).
Methods
275 adult patients who underwent tonsillectomy between 2009 and 2019 were retrospectively
analyzed. Possible risk factors associated with PTH were investigated by univariate
and multivariate logistic regression analyses.
Results
PTH occurred in 39 of 275 patients (14.2%). Regarding underlying diseases, PTH occurred
more frequently in focal infection of IgA nephropathy. Furthermore, bipolar electrocautery
was the other risk factor for PTH on multivariate analysis.
Conclusion
Focal infection of IgA nephropathy and bipolar electrocautery were identified as the
risk factors for PTH.
Keywords
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Article info
Publication history
Published online: October 19, 2022
Accepted:
October 6,
2022
Received:
November 8,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.