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International Journal of Otolaryngology
Volume 2017, Article ID 3275683, 5 pages
Research Article

Time between First and Second Posttonsillectomy Bleeds

1Department of Anesthesiology, Georgetown University, Washington, DC, USA
2Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
3Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV 26505, USA

Correspondence should be addressed to Michele M. Carr; ude.uvw.csh@0400cmm

Received 10 May 2017; Accepted 15 June 2017; Published 7 August 2017

Academic Editor: Gerd J. Ridder

Copyright © 2017 Sheriza Hussain et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To determine the time between first and recurrent posttonsillectomy hemorrhages (PTHs) and find factors related to multiple PTHs. Methods. Retrospective chart review. Results. Of 112 patients, 91 had one PTH, while 21 had recurrent PTHs. Patients with recurrent bleeds had significant differences in indication for tonsillectomy (47.6% had recurrent tonsillitis), prior cardiac conditions (28.6%), transfusions (9.5%), and hematology consults during the initial PTH visit (19%). Bleeding occurred at a mean of 6.1 (range 1–13) days for the first episode and 10 (range 9–18) days for the second episode as compared to 6.65 (range 1–18) days for those who bled once. Recurrent PTH patients were less likely to have had surgical control of the initial bleed . Patients who bled at 7 days or later were more likely to bleed again within one day (OR 23.0, RR 12). Regression analysis showed that age, failure to have operative control of PTH, and surgical indication were most important in predicting recurrent PTH. Conclusions. Operative control of PTH is associated with a better outcome than monitoring alone. Patients with PTH within 7 days of tonsillectomy are likely safe to discharge soon after treatment; those who bleed after 7 days should be monitored longer.