OSA and Postoperative Hemostasis Rate following Tonsillectomy at a Singapore Pediatric Tertiary Hospital

Abstract

Objectives:

Obstructive sleep apnea (OSA) has been hypothesized to be protective against postoperative tonsillectomy hemorrhage, presumably due to the upregulation of prothrombotic factors. This study investigates this possible correlation in patients at our institution.

Methods:

A 6-year retrospective case control study of tonsillectomy only and adenotonsillectomy cases done on children up to 16 years of age, from the end of January 2007 through the end of January 2013. The number of postoperative bleeds that required return to the operating room for hemostasis were recorded.

Results:

There were 2320 tonsillectomy cases. A total of 1581 were adenotonsillectomies and 730 were bilateral tonsillectomies only. Thirty-four cases returned to the operating room for hemostasis. Overall postoperative hemostasis rate was 1.47%. A total of 450 cases were listed as recurrent tonsillitis, 383 listed as OSA (confirmed on polysomnography [PSG]), and 1487 listed as adenotonsillar hypertrophy (no PSG done, presumed OSA). Of the 34 cases that returned to theatre, 9 were OSA cases, 8 were recurrent tonsillitis, and 17 were for hypertrophied tonsils (presumed OSA), giving a postoperative hemostasis rate of 1.39% for the OSA patients and 1.78% for recurrent tonsillitis.

Conclusions:

Despite the possible upregulation of prothrombotic factors in OSA, we found no real difference in postoperative tonsillectomy hemostasis rate in our patients, contrary to findings in other studies.