[Preoperative markers for risk of post-tonsillectomy bleeding in adults].

OBJECTIVE: To identify preoperative markers indicative of an increased risk of postoperative hemorrhage after tonsillectomy in adults. SETTING: Tertiary referral hospital. DESIGN: A retrospective 1:3 case-control study (19 post-tonsillectomy hemorrhage [PTH] cases versus a sample of 58 controls stratified by age and sex). SUBJECTS: Adults over 17 years of age who underwent tonsillectomy from 1989 to 1999 were included. MAIN OUTCOME MEASUREMENTS: Height, weight, percentage of excess weight, body area, systolic and diastolic blood pressure, smoking, drinking, hemoglobin and hematocrit levels, platelet count, partial thromboplastin time, prothrombin activity, fibrinogen, ASA index (physical state classification of the American Society of Anesthesiology), and history of peritonsillar abscess. RESULTS: The risk of PTH in adults was greater in patients with systolic blood pressure > or = 140 mm Hg (OR = 9.46, p = 0.01) and low hematocrit (< 37 for women and < 42 for men, OR = 3.46, p = 0.04). Hemoglobin levels < 12.5 also resulted in an increased risk of PTH in women (OR = 4.79, p = 0.058). CONCLUSIONS: Our findings show that systolic hypertension and anemia may be significant risk factors for PTH in adults.