Department of Otorhinolaryngology, Head Neck Surgery, Medical University of Vienna, Vienna, Austria.
Interdisciplinary Institute for Management and Organisational Behaviour, Vienna, Austria.
Acta Otolaryngol. 2020 Jul;140(7):597-602. doi: 10.1080/00016489.2020.1746829. Epub 2020 Apr 11.
Prolonged hospitalization after tonsillectomy up to three nights was implemented to decrease mortality due to post-tonsillectomy hemorrhage. To assess if extension of postoperative inpatient observation time from one to three nights results in potential benefits following tonsillectomy. Patients who stayed only one night post-tonsillectomy between 1994 and 2006 (Group A) were compared to 1570 patients who stayed three nights postoperatively between 2008 and 2016 (Group B). Complication rate and expense of hospitalization were compared. Published data show that 114 (1.78%) out of 6400 patients in group A had post-tonsillectomy hemorrhage. In this patient group 75.4% ( = 86) of all bleedings occurred after discharge from hospital. However, in group B post-tonsillectomy hemorrhage occurred in 70 (4.5%) and of those only 0.38% ( = 6) developed bleeding episodes on the second or third postoperative day (POD). As observed in group A, the majority of hemorrhage ( = 57; 81.4%) was observed after discharge. Cost analysis reveals a difference of approximately 6 million €for all 32 ENT departments per year in Austria. Extending postoperative hospitalization from one to three nights reveals no benefit after tonsillectomy. Comparison reveals substantial increase of costs for an extended 3 nights inpatient stay.
为降低扁桃体切除术后出血导致的死亡率，术后住院时间延长至 3 晚。评估扁桃体切除术后住院观察时间从 1 晚延长至 3 晚是否能带来潜在获益。将 1994 年至 2006 年期间仅住院 1 晚的患者（A 组）与 2008 年至 2016 年期间住院 3 晚的 1570 例患者（B 组）进行比较。比较并发症发生率和住院费用。已有研究数据显示，A 组 6400 例患者中有 114 例（1.78%）发生扁桃体切除术后出血。该患者组中 75.4%（86 例）的所有出血均发生在出院后。但 B 组中仅 70 例（4.5%）发生扁桃体切除术后出血，其中只有 0.38%（6 例）在术后第 2 或第 3 天发生出血（POD）。与 A 组观察结果一致，大多数出血（81.4%，57 例）发生在出院后。成本分析显示，奥地利所有 32 个耳鼻喉科部门每年因此项措施的费用增加约 600 万欧元。扁桃体切除术后延长住院时间从 1 晚延长至 3 晚并无获益。结果表明，延长 3 晚住院时间的费用显著增加。
