Risk of hemorrhage after outpatient versus inpatient tonsillectomy

INTRODUCTION: This study evaluates the risk of post-tonsillectomy haemorrhage in outpatient surgery compared to conventional inpatient management. MATERIAL AND METHODS: We reviewed 528 tonsillectomies performed at the ENT Department, Rigshospitalet, University of Copenhagen, in the period 1.6.1997 to 31.5.1998. The 264 outpatient tonsillectomies were compared with 264 inpatient procedures. The number of post-operative haemorrhages and the time interval from operation to post-operative bleeding were registered, along with the need for re-operation. Outpatients were discharged 8 hours after surgery, inpatients after 24 hours. RESULTS: Forty-five (8.5%) of 528 tonsillectomies had post-operative haemorrhage complications, 15 (2.8%) patients needed a re-operation. Twenty-five (55%) cases of reactionary haemorrhage occurred 24 hours post-operatively needed another surgery. There were no differences between inpatient and outpatient management. Eighty-nine per cent of all early (0-24 h) post-operative haemorrhages occurred < 8 hours post-operatively. In the time period from 8-24 hours post-operatively there were only three cases of reactionary haemorrhage. The risk of post-operative haemorrhage after discharge was 4.2% and 3.4% after outpatient and inpatient management respectively, a difference of only 0.8%. This makes outpatient tonsillectomy an acceptable alternative to inpatient management.