Assessment of the Association Between Post-tonsillectomy Hemorrhage and Weather Conditions

作者：Mendel Rom; Yitshak-Sade Maayan; Nash Michael; Joshua Ben-Zion^*

来源：Israel Medical Association Journal, 2018, 20(6): 349-353.

• post-tonsillectomy hemorrhage (PTH)
• season
• surgical complication
• tonsillectomy
• weather conditions

Background: The most common complication after tonsillectomy is bleeding. We investigated whether performing the procedure during the summer or the winter affects the bleeding rate.
Objectives: To investigate whether there is an association between meteorological conditions and the occurrence of post tonsillectomy hemorrhage (PTH) in the southern Israel Negev region.
Methods: All patients who underwent tonsillectomy from 2001-2013 at the Soroka Medical Center were included. We collected patient demographic data and indications for surgery. Meteorological data were obtained from a weather station operated by the Israel Ministry of Environmental Protection.
Results: Of 4438 patients who underwent tonsillectomy, with or without adenoidectomy, 432 (9.73%) experienced hemorrhage. Patients who suffered from PTH were significantly older: median age 9.61 years vs. 4.7 years, P < 0.0001. When comparing patients without PTH to those who bled within 0-3 days after surgery, there was a higher risk for bleeding during the warmer seasons: relative risk (RR) 1.38, 95% confidence interval ([95%Cl] 1.07-1.77), 1.45 (95%Cl 1.17-1.80), and 1.62 (95%Cl 1.27-2.06) comparing the winter to spring, summer, and fall, respectively. A statistically significant positive association was also found with the average temperature on the day of surgery. Bleeding more than 3 days after surgery was less likely in summer: RR 0.82, 95%Cl 0.69-0.97. We found no association with temperature on the day of surgery and PTH after postoperative day 3.
Conclusions: Seasonality, and to an extent temperature, seem to play only a minor role in PTH .

• 出版日期2018-6