Incidence of Surgically Managed Post-Tonsillectomy Hemorrhage Associated With NSAID Prescribing for Postoperative Pain Management
ABSTRACT Introduction Tonsillectomy ranks high among the most common pediatric surgical procedures in the United States. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are routinely prescribed to manage post-tonsillectomy pain, but may carry the risk of hemorrhage. Materials and...
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| Veröffentlicht in: | Military medicine 2024-08, Vol.189 (9-10), p.e1955-e1959 |
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| container_end_page | e1959 |
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| container_issue | 9-10 |
| container_start_page | e1955 |
| container_title | Military medicine |
| container_volume | 189 |
| creator | Jacobson, Andrew Mack, Douglas Herrera, Germaine Bowe, Sarah N Highland, Krista B Patzkowski, Michael S |
| description | ABSTRACT
Introduction
Tonsillectomy ranks high among the most common pediatric surgical procedures in the United States. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are routinely prescribed to manage post-tonsillectomy pain, but may carry the risk of hemorrhage.
Materials and Methods
This retrospective, longitudinal, secondary-data analysis study compared the incidence of surgically managed post-tonsillectomy hemorrhage (sPTH) in pediatric patients prescribed ibuprofen at Brooke Army Medical Center (BAMC) after tonsillectomy compared to a similar cohort of pediatric patients at the Children’s Hospital of Philadelphia (CHOP) not prescribed ibuprofen. Additional regression analysis examined predictors of sPTH at BAMC.
Results
The odds of sPTH was lower in patients who were prescribed ibuprofen at BAMC, relative to patients who were not at CHOP (OR 0.57, 95% CI, 0.37, 0.87; P |
| doi_str_mv | 10.1093/milmed/usae194 |
| format | Article |
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Introduction
Tonsillectomy ranks high among the most common pediatric surgical procedures in the United States. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are routinely prescribed to manage post-tonsillectomy pain, but may carry the risk of hemorrhage.
Materials and Methods
This retrospective, longitudinal, secondary-data analysis study compared the incidence of surgically managed post-tonsillectomy hemorrhage (sPTH) in pediatric patients prescribed ibuprofen at Brooke Army Medical Center (BAMC) after tonsillectomy compared to a similar cohort of pediatric patients at the Children’s Hospital of Philadelphia (CHOP) not prescribed ibuprofen. Additional regression analysis examined predictors of sPTH at BAMC.
Results
The odds of sPTH was lower in patients who were prescribed ibuprofen at BAMC, relative to patients who were not at CHOP (OR 0.57, 95% CI, 0.37, 0.87; P < 0.01). In a generalized linear model evaluating BAMC patient data, there was a lack of a relationship between reason for tonsillectomy (tonsillitis versus tonsillar obstruction), primary procedure (tonsillectomy-only versus tonsillectomy with adenoidectomy), and presence of a co-occurring procedure.
Conclusions
Post-tonsillectomy ibuprofen prescribing practices were not associated with an elevated risk of sPTH, relative to patients at CHOP not exposed to ibuprofen.</description><identifier>ISSN: 0026-4075</identifier><identifier>ISSN: 1930-613X</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.1093/milmed/usae194</identifier><identifier>PMID: 38758073</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Adolescent ; Anti-Inflammatory Agents, Non-Steroidal - adverse effects ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; Child ; Child, Preschool ; Female ; Hemorrhage ; Humans ; Ibuprofen - adverse effects ; Ibuprofen - therapeutic use ; Incidence ; Longitudinal Studies ; Male ; Nonsteroidal anti-inflammatory drugs ; Pain management ; Pain, Postoperative - drug therapy ; Pediatrics ; Postoperative Hemorrhage - epidemiology ; Postoperative Hemorrhage - etiology ; Postoperative period ; Retrospective Studies ; Throat surgery ; Tonsillectomy - adverse effects ; Tonsillectomy - methods ; Tonsillectomy - statistics & numerical data</subject><ispartof>Military medicine, 2024-08, Vol.189 (9-10), p.e1955-e1959</ispartof><rights>Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US. 2023</rights><rights>Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c282t-43fb2d0cc461f5ee774acb9dc0f1ad08d42723b33f27f34dd6697a862ac0530a3</cites><orcidid>0000-0002-6201-3793 ; 0000-0003-3815-2571 ; 0000-0001-5623-8075</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38758073$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacobson, Andrew</creatorcontrib><creatorcontrib>Mack, Douglas</creatorcontrib><creatorcontrib>Herrera, Germaine</creatorcontrib><creatorcontrib>Bowe, Sarah N</creatorcontrib><creatorcontrib>Highland, Krista B</creatorcontrib><creatorcontrib>Patzkowski, Michael S</creatorcontrib><title>Incidence of Surgically Managed Post-Tonsillectomy Hemorrhage Associated With NSAID Prescribing for Postoperative Pain Management</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>ABSTRACT
Introduction
Tonsillectomy ranks high among the most common pediatric surgical procedures in the United States. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are routinely prescribed to manage post-tonsillectomy pain, but may carry the risk of hemorrhage.
Materials and Methods
This retrospective, longitudinal, secondary-data analysis study compared the incidence of surgically managed post-tonsillectomy hemorrhage (sPTH) in pediatric patients prescribed ibuprofen at Brooke Army Medical Center (BAMC) after tonsillectomy compared to a similar cohort of pediatric patients at the Children’s Hospital of Philadelphia (CHOP) not prescribed ibuprofen. Additional regression analysis examined predictors of sPTH at BAMC.
Results
The odds of sPTH was lower in patients who were prescribed ibuprofen at BAMC, relative to patients who were not at CHOP (OR 0.57, 95% CI, 0.37, 0.87; P < 0.01). In a generalized linear model evaluating BAMC patient data, there was a lack of a relationship between reason for tonsillectomy (tonsillitis versus tonsillar obstruction), primary procedure (tonsillectomy-only versus tonsillectomy with adenoidectomy), and presence of a co-occurring procedure.
Conclusions
Post-tonsillectomy ibuprofen prescribing practices were not associated with an elevated risk of sPTH, relative to patients at CHOP not exposed to ibuprofen.</description><subject>Adolescent</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Ibuprofen - adverse effects</subject><subject>Ibuprofen - therapeutic use</subject><subject>Incidence</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Pain management</subject><subject>Pain, Postoperative - drug therapy</subject><subject>Pediatrics</subject><subject>Postoperative Hemorrhage - epidemiology</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Postoperative period</subject><subject>Retrospective Studies</subject><subject>Throat surgery</subject><subject>Tonsillectomy - adverse effects</subject><subject>Tonsillectomy - methods</subject><subject>Tonsillectomy - statistics & numerical data</subject><issn>0026-4075</issn><issn>1930-613X</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1P3DAQQC0EKlvotcfKUi_0EBjHiZ0cV9CWlfhYCapyixx7vBgl9mInlfbYf97ALpdeOFkav3ka6RHymcEpg5qf9a7r0ZyNSSGriz0yYzWHTDD-sE9mALnICpDlIfmY0hMAK-qKfSCHvJJlBZLPyN-F186g10iDpXdjXDmtum5Dr5VXKzR0GdKQ3QefXNehHkK_oZfYhxgfp286Tylop4YJ_O2GR3pzN19c0GXEpKNrnV9RG-KrI6wxqsH9QbpUzu_0PfrhmBxY1SX8tHuPyK8f3-_PL7Or25-L8_lVpvMqH7KC2zY3oHUhmC0RpSyUbmujwTJloDJFLnPecm5zaXlhjBC1VJXIlYaSg-JH5GTrXcfwPGIamt4ljV2nPIYxNRxKIURZCjmhX_9Dn8IY_XRdwxlMoAQmJup0S-kYUopom3V0vYqbhkHzEqfZxml2caaFLzvt2L7M3_C3GhPwbQuEcf2e7B8O2pzW</recordid><startdate>20240830</startdate><enddate>20240830</enddate><creator>Jacobson, Andrew</creator><creator>Mack, Douglas</creator><creator>Herrera, Germaine</creator><creator>Bowe, Sarah N</creator><creator>Highland, Krista B</creator><creator>Patzkowski, Michael S</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6201-3793</orcidid><orcidid>https://orcid.org/0000-0003-3815-2571</orcidid><orcidid>https://orcid.org/0000-0001-5623-8075</orcidid></search><sort><creationdate>20240830</creationdate><title>Incidence of Surgically Managed Post-Tonsillectomy Hemorrhage Associated With NSAID Prescribing for Postoperative Pain Management</title><author>Jacobson, Andrew ; Mack, Douglas ; Herrera, Germaine ; Bowe, Sarah N ; Highland, Krista B ; Patzkowski, Michael S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c282t-43fb2d0cc461f5ee774acb9dc0f1ad08d42723b33f27f34dd6697a862ac0530a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Ibuprofen - adverse effects</topic><topic>Ibuprofen - therapeutic use</topic><topic>Incidence</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Pain management</topic><topic>Pain, Postoperative - drug therapy</topic><topic>Pediatrics</topic><topic>Postoperative Hemorrhage - epidemiology</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Postoperative period</topic><topic>Retrospective Studies</topic><topic>Throat surgery</topic><topic>Tonsillectomy - adverse effects</topic><topic>Tonsillectomy - methods</topic><topic>Tonsillectomy - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jacobson, Andrew</creatorcontrib><creatorcontrib>Mack, Douglas</creatorcontrib><creatorcontrib>Herrera, Germaine</creatorcontrib><creatorcontrib>Bowe, Sarah N</creatorcontrib><creatorcontrib>Highland, Krista B</creatorcontrib><creatorcontrib>Patzkowski, Michael S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Military medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jacobson, Andrew</au><au>Mack, Douglas</au><au>Herrera, Germaine</au><au>Bowe, Sarah N</au><au>Highland, Krista B</au><au>Patzkowski, Michael S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of Surgically Managed Post-Tonsillectomy Hemorrhage Associated With NSAID Prescribing for Postoperative Pain Management</atitle><jtitle>Military medicine</jtitle><addtitle>Mil Med</addtitle><date>2024-08-30</date><risdate>2024</risdate><volume>189</volume><issue>9-10</issue><spage>e1955</spage><epage>e1959</epage><pages>e1955-e1959</pages><issn>0026-4075</issn><issn>1930-613X</issn><eissn>1930-613X</eissn><abstract>ABSTRACT
Introduction
Tonsillectomy ranks high among the most common pediatric surgical procedures in the United States. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are routinely prescribed to manage post-tonsillectomy pain, but may carry the risk of hemorrhage.
Materials and Methods
This retrospective, longitudinal, secondary-data analysis study compared the incidence of surgically managed post-tonsillectomy hemorrhage (sPTH) in pediatric patients prescribed ibuprofen at Brooke Army Medical Center (BAMC) after tonsillectomy compared to a similar cohort of pediatric patients at the Children’s Hospital of Philadelphia (CHOP) not prescribed ibuprofen. Additional regression analysis examined predictors of sPTH at BAMC.
Results
The odds of sPTH was lower in patients who were prescribed ibuprofen at BAMC, relative to patients who were not at CHOP (OR 0.57, 95% CI, 0.37, 0.87; P < 0.01). In a generalized linear model evaluating BAMC patient data, there was a lack of a relationship between reason for tonsillectomy (tonsillitis versus tonsillar obstruction), primary procedure (tonsillectomy-only versus tonsillectomy with adenoidectomy), and presence of a co-occurring procedure.
Conclusions
Post-tonsillectomy ibuprofen prescribing practices were not associated with an elevated risk of sPTH, relative to patients at CHOP not exposed to ibuprofen.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>38758073</pmid><doi>10.1093/milmed/usae194</doi><orcidid>https://orcid.org/0000-0002-6201-3793</orcidid><orcidid>https://orcid.org/0000-0003-3815-2571</orcidid><orcidid>https://orcid.org/0000-0001-5623-8075</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Military medicine, 2024-08, Vol.189 (9-10), p.e1955-e1959 |
| issn | 0026-4075 1930-613X 1930-613X |
| language | eng |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adolescent Anti-Inflammatory Agents, Non-Steroidal - adverse effects Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Child Child, Preschool Female Hemorrhage Humans Ibuprofen - adverse effects Ibuprofen - therapeutic use Incidence Longitudinal Studies Male Nonsteroidal anti-inflammatory drugs Pain management Pain, Postoperative - drug therapy Pediatrics Postoperative Hemorrhage - epidemiology Postoperative Hemorrhage - etiology Postoperative period Retrospective Studies Throat surgery Tonsillectomy - adverse effects Tonsillectomy - methods Tonsillectomy - statistics & numerical data |
| title | Incidence of Surgically Managed Post-Tonsillectomy Hemorrhage Associated With NSAID Prescribing for Postoperative Pain Management |
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