Departmental audit of tonsillectomy haemorrhage rates: pitfalls in interpretation

• Published in: Journal of laryngology and otology Vol. 121; no. 3; pp. 262 - 265
• Main Authors: Hamid, W A Abdel, Flood, L M, Martin, F W
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.03.2007
• Subjects: Adolescent; Adult; Age Factors; Aged; Audit; Biological and medical sciences; Electrocoagulation; Female; Haemorrhage; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Hemostasis, Surgical - methods; Humans; Informed Consent; Ligation; Main Articles; Male; Medical Audit; Medical sciences; Middle Aged; Otorhinolaryngology. Stomatology; Postoperative Hemorrhage - etiology; Retrospective Studies; Risk Factors; Sex Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Tonsillectomy; Tonsillectomy - adverse effects; Tonsillectomy - methods; Informed Consent; Audit; Haemorrhage; Tonsillectomy; Human; Treatment; Surgery; Complication; Informed consent; ENT; Hemorrhage
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215106002696

Concerns that a largely anecdotal increase in post tonsillectomy haemorrhage rates was related to the introduction of disposable instruments have prompted much investigation. The result has been, rather, to highlight other variables influencing this risk, but especially to insist on the following: 1 Training in traditional ‘cold’ techniques.2 Regular departmental audit of haemorrhage rates.3 Presentation of such data to patients to ensure informed consent. This audit demonstrates the pitfalls in interpretation of crude data, unadjusted for case-mix, in predicting individual patient risk and in national ranking of unit performance.