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Bennett, A. M. D., Clark, A. B. 
ORCID: https://orcid.org/0000-0003-2965-8941, Bath, A. P. and Montgomery, P. Q.
(2005)
Meta-analysis of the timing of haemorrhage after tonsillectomy: An important factor in determining the safety of performing tonsillectomy as a day case procedure.
Clinical Otolaryngology, 30 (5).
pp. 418-423.
ISSN 1749-4486
Abstract
Objectives: To perform a meta-analysis of studies of the timing of primary tonsillectomy haemorrhage. In particular to compare the difference in risk between 0–8 and 8–24 h; that is whether overnight inpatient tonsillectomy is required. Design: Medline search of all tonsillectomy studies to perform a meta-analysis of the timing of primary haemorrhages. Setting: Literature-based study. Participants: All adult and paediatric tonsillectomy studies giving the absolute number and timing of all primary haemorrhages. Main outcome measures: The overall incidence of haemorrhage occurring between 0–8 and 8–24 h. The overall incidence of haemorrhage for each of the first 24 h after operation. Compare risk of a bleed occurring 0–8, 8–24 and >24 h where data were available. Results: From a 1.4% overall risk of a primary haemorrhage only one in 14 occur after 8 h, i.e. 0.1% (95% CI = 0.08–0.16%). A total of 833 patients would require to be kept overnight in order to identify one case of bleeding after 8 h. Conclusions: Little benefit was conferred from overnight admission from the point of view of monitoring for primary haemorrhage. A case can be made for either day-case tonsillectomy (hospital stay over the period in which 93% of primary haemorrhages would occur) or the ‘belt-and-braces’ approach of a 1-week stay (during which all haemorrhages would occur) but current 24-h admission appears illogical.
| Item Type: | Article |
|---|---|
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) |
| Depositing User: | EPrints Services |
| Date Deposited: | 25 Nov 2010 11:09 |
| Last Modified: | 08 Aug 2024 11:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/12211 |
| DOI: | 10.1111/j.1365-2273.2005.01060.x |
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