Temporal fluctuations of post-tonsillectomy haemorrhage
Purpose Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhag...
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| Veröffentlicht in: | European archives of oto-rhino-laryngology 2022-03, Vol.279 (3), p.1601-1607 |
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| container_title | European archives of oto-rhino-laryngology |
| container_volume | 279 |
| creator | Grasl, Stefan Mekhail, Patrick Janik, Stefan Grasl, Christoph M. Vyskocil, Erich Erovic, Boban M. Arnoldner, Christoph Landegger, Lukas D. |
| description | Purpose
Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff.
Methods
This retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney
U
test, and Chi-square goodness of fit tests were used to detect potential differences.
Results
A total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: |
| doi_str_mv | 10.1007/s00405-021-07080-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8897317</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2576648859</sourcerecordid><originalsourceid>FETCH-LOGICAL-c446t-8953ce2d008d5a595f06a235745660bac8134d86b8ffa2c87c37b2a62c4d5c6c3</originalsourceid><addsrcrecordid>eNp9kEtLAzEUhYMoWqt_wIV06SZ6885sBBFfUHBT1yHNZNopM5OazAj990Zbi25cXS73nHMPH0IXBK4JgLpJABwEBkowKNCAyQEaEc445orKQzSCginMuVIn6DSlFQAIXrBjdMK4EKoQxQipmW_XIdpmUjWD6wfb16FLk1BN1iH1uM9L3TTe9aHdTJbWtyHGpV34M3RU2Sb5890co7fHh9n9M56-Pr3c302x41z2WBeCOU9LAF0KKwpRgbSUCcWFlDC3ThPGSy3nuqosdVo5pubUSup4KZx0bIxut7nrYd760vmuz2XNOtatjRsTbG3-Xrp6aRbhw2hdKEZUDrjaBcTwPvjUm7ZOzjeN7XwYkqFCScm1FkWW0q3UxZBS9NX-DQHzRdxsiZtM3HwTNySbLn8X3Ft-EGcB2wpSPnULH80qDLHL0P6L_QSNWo1g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2576648859</pqid></control><display><type>article</type><title>Temporal fluctuations of post-tonsillectomy haemorrhage</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Grasl, Stefan ; Mekhail, Patrick ; Janik, Stefan ; Grasl, Christoph M. ; Vyskocil, Erich ; Erovic, Boban M. ; Arnoldner, Christoph ; Landegger, Lukas D.</creator><creatorcontrib>Grasl, Stefan ; Mekhail, Patrick ; Janik, Stefan ; Grasl, Christoph M. ; Vyskocil, Erich ; Erovic, Boban M. ; Arnoldner, Christoph ; Landegger, Lukas D.</creatorcontrib><description>Purpose
Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff.
Methods
This retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney
U
test, and Chi-square goodness of fit tests were used to detect potential differences.
Results
A total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: < 1–19) days. 64.7% (
n
= 194) of all emergency surgeries had to be performed during evening and night hours (6 pm—6 am) (
p
< 0.0001). Compared to diurnal incidents, the risk of a nocturnal PTH event increased, the longer ago the initial surgery was (
p
< 0.0001). No seasonal variations were identified. Age, sex, and details of the initial procedure had no significant influence on the start time according to the surgical protocol.
Conclusion
The discovered temporal fluctuations of PTH are of relevance for patient awareness and preoperative education. Due to possible life-threatening complications, management of severe PTH requires specific resources and trained medical staff on call.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-021-07080-1</identifier><identifier>PMID: 34557959</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Child ; Head and Neck Surgery ; Humans ; Medicine ; Medicine & Public Health ; Miscellaneous ; Neurosurgery ; Otorhinolaryngology ; Postoperative Hemorrhage - diagnosis ; Postoperative Hemorrhage - epidemiology ; Postoperative Hemorrhage - etiology ; Postoperative Period ; Retrospective Studies ; Tonsillectomy - methods</subject><ispartof>European archives of oto-rhino-laryngology, 2022-03, Vol.279 (3), p.1601-1607</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-8953ce2d008d5a595f06a235745660bac8134d86b8ffa2c87c37b2a62c4d5c6c3</citedby><cites>FETCH-LOGICAL-c446t-8953ce2d008d5a595f06a235745660bac8134d86b8ffa2c87c37b2a62c4d5c6c3</cites><orcidid>0000-0002-9660-2625</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00405-021-07080-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00405-021-07080-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34557959$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grasl, Stefan</creatorcontrib><creatorcontrib>Mekhail, Patrick</creatorcontrib><creatorcontrib>Janik, Stefan</creatorcontrib><creatorcontrib>Grasl, Christoph M.</creatorcontrib><creatorcontrib>Vyskocil, Erich</creatorcontrib><creatorcontrib>Erovic, Boban M.</creatorcontrib><creatorcontrib>Arnoldner, Christoph</creatorcontrib><creatorcontrib>Landegger, Lukas D.</creatorcontrib><title>Temporal fluctuations of post-tonsillectomy haemorrhage</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><description>Purpose
Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff.
Methods
This retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney
U
test, and Chi-square goodness of fit tests were used to detect potential differences.
Results
A total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: < 1–19) days. 64.7% (
n
= 194) of all emergency surgeries had to be performed during evening and night hours (6 pm—6 am) (
p
< 0.0001). Compared to diurnal incidents, the risk of a nocturnal PTH event increased, the longer ago the initial surgery was (
p
< 0.0001). No seasonal variations were identified. Age, sex, and details of the initial procedure had no significant influence on the start time according to the surgical protocol.
Conclusion
The discovered temporal fluctuations of PTH are of relevance for patient awareness and preoperative education. Due to possible life-threatening complications, management of severe PTH requires specific resources and trained medical staff on call.</description><subject>Adult</subject><subject>Child</subject><subject>Head and Neck Surgery</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Miscellaneous</subject><subject>Neurosurgery</subject><subject>Otorhinolaryngology</subject><subject>Postoperative Hemorrhage - diagnosis</subject><subject>Postoperative Hemorrhage - epidemiology</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Postoperative Period</subject><subject>Retrospective Studies</subject><subject>Tonsillectomy - methods</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEUhYMoWqt_wIV06SZ6885sBBFfUHBT1yHNZNopM5OazAj990Zbi25cXS73nHMPH0IXBK4JgLpJABwEBkowKNCAyQEaEc445orKQzSCginMuVIn6DSlFQAIXrBjdMK4EKoQxQipmW_XIdpmUjWD6wfb16FLk1BN1iH1uM9L3TTe9aHdTJbWtyHGpV34M3RU2Sb5890co7fHh9n9M56-Pr3c302x41z2WBeCOU9LAF0KKwpRgbSUCcWFlDC3ThPGSy3nuqosdVo5pubUSup4KZx0bIxut7nrYd760vmuz2XNOtatjRsTbG3-Xrp6aRbhw2hdKEZUDrjaBcTwPvjUm7ZOzjeN7XwYkqFCScm1FkWW0q3UxZBS9NX-DQHzRdxsiZtM3HwTNySbLn8X3Ft-EGcB2wpSPnULH80qDLHL0P6L_QSNWo1g</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Grasl, Stefan</creator><creator>Mekhail, Patrick</creator><creator>Janik, Stefan</creator><creator>Grasl, Christoph M.</creator><creator>Vyskocil, Erich</creator><creator>Erovic, Boban M.</creator><creator>Arnoldner, Christoph</creator><creator>Landegger, Lukas D.</creator><general>Springer Berlin Heidelberg</general><scope>C6C</scope><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>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9660-2625</orcidid></search><sort><creationdate>20220301</creationdate><title>Temporal fluctuations of post-tonsillectomy haemorrhage</title><author>Grasl, Stefan ; Mekhail, Patrick ; Janik, Stefan ; Grasl, Christoph M. ; Vyskocil, Erich ; Erovic, Boban M. ; Arnoldner, Christoph ; Landegger, Lukas D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-8953ce2d008d5a595f06a235745660bac8134d86b8ffa2c87c37b2a62c4d5c6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Child</topic><topic>Head and Neck Surgery</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Miscellaneous</topic><topic>Neurosurgery</topic><topic>Otorhinolaryngology</topic><topic>Postoperative Hemorrhage - diagnosis</topic><topic>Postoperative Hemorrhage - epidemiology</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Postoperative Period</topic><topic>Retrospective Studies</topic><topic>Tonsillectomy - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grasl, Stefan</creatorcontrib><creatorcontrib>Mekhail, Patrick</creatorcontrib><creatorcontrib>Janik, Stefan</creatorcontrib><creatorcontrib>Grasl, Christoph M.</creatorcontrib><creatorcontrib>Vyskocil, Erich</creatorcontrib><creatorcontrib>Erovic, Boban M.</creatorcontrib><creatorcontrib>Arnoldner, Christoph</creatorcontrib><creatorcontrib>Landegger, Lukas D.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grasl, Stefan</au><au>Mekhail, Patrick</au><au>Janik, Stefan</au><au>Grasl, Christoph M.</au><au>Vyskocil, Erich</au><au>Erovic, Boban M.</au><au>Arnoldner, Christoph</au><au>Landegger, Lukas D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Temporal fluctuations of post-tonsillectomy haemorrhage</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>279</volume><issue>3</issue><spage>1601</spage><epage>1607</epage><pages>1601-1607</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><abstract>Purpose
Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff.
Methods
This retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney
U
test, and Chi-square goodness of fit tests were used to detect potential differences.
Results
A total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: < 1–19) days. 64.7% (
n
= 194) of all emergency surgeries had to be performed during evening and night hours (6 pm—6 am) (
p
< 0.0001). Compared to diurnal incidents, the risk of a nocturnal PTH event increased, the longer ago the initial surgery was (
p
< 0.0001). No seasonal variations were identified. Age, sex, and details of the initial procedure had no significant influence on the start time according to the surgical protocol.
Conclusion
The discovered temporal fluctuations of PTH are of relevance for patient awareness and preoperative education. Due to possible life-threatening complications, management of severe PTH requires specific resources and trained medical staff on call.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34557959</pmid><doi>10.1007/s00405-021-07080-1</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9660-2625</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0937-4477 |
| ispartof | European archives of oto-rhino-laryngology, 2022-03, Vol.279 (3), p.1601-1607 |
| issn | 0937-4477 1434-4726 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8897317 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Child Head and Neck Surgery Humans Medicine Medicine & Public Health Miscellaneous Neurosurgery Otorhinolaryngology Postoperative Hemorrhage - diagnosis Postoperative Hemorrhage - epidemiology Postoperative Hemorrhage - etiology Postoperative Period Retrospective Studies Tonsillectomy - methods |
| title | Temporal fluctuations of post-tonsillectomy haemorrhage |
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