Meta-analysis of the timing of haemorrhage after tonsillectomy: An important factor in determining the safety of performing tonsillectomy as a day case procedure

Bennett, A. M. D., Clark, A. B., 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

Full text not available from this repository. (Request a copy)

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) Faculty of Science > Research Groups > Statistics
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:09
Last Modified:	28 Mar 2025 04:10
URI:	https://ueaeprints.uea.ac.uk/id/eprint/12211
DOI:	10.1111/j.1365-2273.2005.01060.x

Actions (login required)

View Item