Sains Malaysiana 48(3)(2019): 621–627

http://dx.doi.org/10.17576/jsm-2019-4803-15

 

Incidence and Risk Factors of Post-Tonsillectomy Haemorrhage in Patients Operated during the 2012-2016 Period at ENT Department Hospital Serdang, Malaysia

(Kejadian dan Faktor Risiko Pendarahan Selepas Tonsilektomi bagi Pesakit yang Dibedah Sepanjang Tempoh 2012-2016 di Jabatan ENT Hospital Serdang, Malaysia)

 

SETHU T. SUBHA*, ATIQAH FARAH, Z., CHONG, K.M., NOR ASHIKIN, A.H. & MUHAMMAD FIKRI, S.

 

Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia

 

Diserahkan: 5 Oktober 2018/Diterima: 11 Januari 2019

 

ABSTRACT

Tonsillectomy is the most common operation performed in the field of Ear, Nose and Throat (ENT) Surgical speciality. Post-tonsillectomy haemorrhage remains a significant complication leading to morbidity and occasional mortality. The main objective of this study was to evaluate the incidence and risk factors of post-tonsillectomy haemorrhage in a cohort of patients who had been operated at our institution. This retrospective cohort study reviewed the medical records of all patients who underwent tonsillectomy from 1st January 2012 to 31st December 2016. Data on patient’s age, gender, race, smoking habit, indication for tonsillectomy, duration and technique of surgery, usage of post-operative drugs and management were recorded. Out of 315 patients included this study, 54.9% were adults (12 years and above) and majority (86.3%) of them were of Malay descent. The common indication for tonsillectomy was recurrent tonsillitis (84.4%). This study showed significant associations (p<0.05) between age, smoking and the use of steroids with post-tonsillectomy haemorrhage. However, there was no significant association between gender, race, use of post-operative drugs (non-steroidal anti-inflammatory drugs, antibiotics), duration of surgery, the technique of surgery and post-tonsillectomy haemorrhage. The incidence of post-tonsillectomy haemorrhage in our population was 10.5 % (n=33) and among them, 54.5 % (n=18) required surgical intervention. Our study demonstrated that older patients (12 years and above), smokers and the use of steroids during the post-operative period have increased the risk of post-tonsillectomy haemorrhage. An awareness of these risk factors should help to minimize the post-tonsillectomy haemorrhage and improve the patient outcomes.

 

Keywords: Post tonsillectomy haemorrhage (PTH); risk factors; smokers; steroids

 

ABSTRAK

Tonsilektomi adalah pembedahan yang paling biasa dilakukan dalam bidang kepakaran Telinga, Hidung dan Tekak (ENT). Pendarahan selepas pembedahan tonsilektomi adalah komplikasi yang ketara membawa kepada morbiditi dan mortaliti sekali sekala. Objektif utama kajian ini adalah untuk menilai kejadian dan faktor risiko untuk mendapat pendarahan selepas pembedahan tonsilektomi dalam kohort pesakit yang telah menjalani pembedahan di institusi kami. Kajian kohort retrospektif ini mengkaji rekod perubatan daripada semua pesakit yang menjalani tonsilektomi dari 1 Januari 2012 hingga 31 Disember 2016. Data pesakit seperti umur, jantina, bangsa, tabiat merokok, petunjuk untuk menjalani tonsilektomi, tempoh dan teknik pembedahan, penggunaan ubat-ubatan dan pengurusan selepas pembedahan telah direkodkan. Antara 315 pesakit termasuk kajian ini, 54.9% adalah orang dewasa (12 tahun ke atas) dan majoriti (86.3%) daripadanya adalah berbangsa Melayu. Penunjuk umum untuk pembedahan adalah tonsillitis berulang (84.4%) dalam kalangan pesakit kami. Kajian ini menunjukkan kaitan yang signifikan (p<0.05) antara umur, merokok dan penggunaan steroid dengan pendarahan selepas pembedahan tonsilektomi. Walau bagaimanapun, tidak terdapat hubungan yang signifikan antara jantina, bangsa, penggunaan ubat-ubatan selepas pembedahan (NSAIDS, antibiotik), tempoh pembedahan, teknik pembedahan dengan pendarahan selepas pembedahan tonsilektomi. Insiden pendarahan selepas tonsilektomi dalam populasi kami adalah 10.5% (n=33) dan antara mereka 54.5% (n=18) memerlukan rawatan intervensi surgeri. Kajian ini menunjukkan bahawa pesakit yang lebih tua (12 tahun ke atas), perokok dan penggunaan steroid dalam tempoh selepas pembedahan mempunyai risiko yang lebih tinggi untuk mendapat pendarahan selepas pembedahan. Kesedaran mengenai faktor risiko ini harus membantu meminimumkan pendarahan selepas pembedahan tonsilektomi dan meningkatkan penjagaan dan keadaan pesakit.

 

Kata kunci: Faktor risiko; pendarahan pasca-tonsilektomi (PTH); perokok; steroid

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*Pengarang untuk surat-menyurat; email: subhast2@yahoo.com

 

 

 

 

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