Are More Adults Bleeding After Tonsillectomy Than in the Past

Sunday, September 29, 2024

1:30 PM – 1:36 PM EDT

Location: MBCC, 206

Disclosure(s):

Deepthi S. Akella, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Chloe J. Cottone, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Dylan Z. Erwin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Post-tonsillectomy bleeding (PTH) rates have increased in children over the last decade. The purpose of this study was to determine whether PTH incidence in adults had also increased over the last 15 years.

Methods: A retrospective study was conducted using TriNetX, a global EHR database. A search for patients 18 years and older within the US Collaborative Network who had undergone tonsillectomy (CPT codes 42821 or 42826) yielded 72,232 subjects. Those diagnosed with PTH were identified using ICD-10 codes J95.830 or K91.840 and those who returned to the OR to control PTH were identified using CPT 42962. Any PTH event that occurred within 14 days of a tonsillectomy was tabulated annually from 2008 to 2022. Analgesics given within 14 days following a tonsillectomy were also tabulated annually from 2008 to 2022. Analgesics included codeine, ibuprofen, acetaminophen, oxycodone, ketorolac, and hydrocodone. Mann-Kendall test for monotonic trend was used to examine significant trends in postoperative bleeding and analgesic use.

Results: Mean age at tonsillectomy was 32.8 years (SD=13.8). 4.1% were diagnosed with PTH in 2008 which trended upwards to 6.2% by 2022 (P=.0030). Patients who returned to the OR to control postoperative bleeding also trended upwards, rising from 0.7% in 2008 to 2.4% in 2022 (P <.0001). Use of codeine post-tonsillectomy trended downwards from 6.9% in 2008 to 2.5% in 2022 (P=.0022). Use of ibuprofen, acetaminophen, ketorolac, and oxycodone trended upwards from 1.6% to 23.4% (P=.0005), 36.1% to 78.6% (P <.0001), 1.5% to 11.9% (P <.0001), and 20.6% to 63.6% (P <.0001) respectively. No change was detected in use of hydrocodone with a mean percentage of 27.8%.

Conclusions: Analgesics used post-tonsillectomy in adults have changed over the last 15 years. There has been a concurrent increase in post-tonsillectomy bleeding which bears more investigation to determine its causes.

Presenting Author(s)

Deepthi S. Akella, MS

Medical Student
University of the Incarnate Word School of Osteopathic Medicine
San Antonio, Texas, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Chloe J. Cottone, BA

Medical Student
Jacobs School Medicine and Biomedical Sciences at the University at Buffalo
Bufalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
CM

Chennai A. Marcus, BA

Oakland University William Beaumont School of Medicine, United States

Disclosure information not submitted.
Dylan Z. Erwin, MD

Resident Physician
Long School of Medicine at the University of Texas Health Science Center at San Antonio
San Antonio, Texas, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Michele M. Carr, DDS, MD, PhD

Professor
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Department of Otolaryngology
Williamsville, New York, United States

Disclosure information not submitted.