Is weekend surgery a risk factor for post-tonsillectomy haemorrhage?

Abstract Background: Tonsillectomy is a common, low-risk procedure. Post-tonsillectomy haemorrhage remains the most serious complication. Recent nationwide studies in the UK have identified an increased morbidity and mortality for both high-risk and low-risk elective general surgery performed at the weekend. Methods: Data for tonsillectomies performed at a district general hospital over a three-year period were retrospectively reviewed. The same group of surgeons performed elective tonsillectomies on both weekends and weekdays. All patients who developed a post-tonsillectomy haemorrhage were identified and the day of original operation was noted. Results: Between 2010 and 2013, 2208 (94.00 per cent) elective tonsillectomies were performed on a weekday and 141 (6.00 per cent) were performed on the weekend. Post-tonsillectomy haemorrhages occurred in 104 patients (4.71 per cent) who underwent their procedure on a weekday and in 10 patients (7.09 per cent) who had their surgery at the weekend (p = 0.20). Conclusion: There is no difference in the rate of post-tonsillectomy haemorrhage for procedures performed on a weekday or weekend.

[1]  M. Burton,et al.  Coblation versus other surgical techniques for tonsillectomy. , 2017, The Cochrane database of systematic reviews.

[2]  S. Roberts,et al.  Weekend emergency admissions and mortality in England and Wales , 2015, The Lancet.

[3]  J. Werner,et al.  Post-tonsillectomy hemorrhage—some facts will never change , 2015, European Archives of Oto-Rhino-Laryngology.

[4]  J. Stalfors,et al.  Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden , 2015, European Archives of Oto-Rhino-Laryngology.

[5]  K. Konieczny,et al.  Application of the Paediatric Throat Disorders Outcome Test (T-14) for tonsillectomy and adenotonsillectomy. , 2013, Annals of the Royal College of Surgeons of England.

[6]  A. Bottle,et al.  Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics , 2013, BDJ.

[7]  G. Rudge,et al.  Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: a retrospective database study of national health service hospitals in England , 2012, BMC Health Services Research.

[8]  M. Hellmich,et al.  Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials , 2011, European Archives of Oto-Rhino-Laryngology.

[9]  A. Majeed,et al.  Weekend mortality for emergency admissions. A large, multicentre study , 2010, Quality and Safety in Health Care.

[10]  H. Genzwürker,et al.  Tonsillectomy in children. , 2008, Deutsches Arzteblatt international.

[11]  C. O'connor,et al.  Day of Admission and Clinical Outcomes for Patients Hospitalized for Heart Failure: Findings From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) , 2008, Circulation. Heart failure.

[12]  D. Becker Do hospitals provide lower quality care on weekends? , 2007, Health services research.

[13]  S. Ziemer,et al.  A Practical Concept for Preoperative Identification of Patients with Impaired Primary Hemostasis , 2004, Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis.

[14]  J. Meulen,et al.  National Prospective Tonsillectomy Audit: Electronic data collection and feedback , 2003 .