Akella Deepthi, Cottone Chloe, Raghavan Maya, Varavenkataraman Gaayathri, Marcus Chennai A, Erwin Dylan Z, Carr Michele M
School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, Texas, USA.
Jacobs School Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA.
Laryngoscope. 2025 Jun;135(6):1958-1963. doi: 10.1002/lary.32016. Epub 2025 Jan 27.
Post-tonsillectomy hemorrhage (PTH) rates have increased in children over the last decade. This study aimed to determine whether PTH incidence in adults had also increased over the last 15 years.
Retrospective study.
TriNetX database.
A search was conducted using TriNetX for patients 18 years and older within the US Collaborative Network who had undergone tonsillectomy (CPT codes 42821 or 42826) and yielded 72,232 subjects. PTH diagnoses were identified using ICD-10 codes J95.830 or K91.840, and those who returned to the operating room (RTOR) to control PTH were identified using CPT 42962. PTH events that occurred and analgesics given following 14 days of tonsillectomy were tabulated annually from 2008 to 2022. Mann-Kendall test for monotonic trend examined significant trends in PTH and analgesic use.
Mean age at tonsillectomy was 32.8 years (SD = 13.8). 4.1% were diagnosed with PTH in 2008, compared with 6.2% by 2022 (p = 0.0030). In 2008, 0.7% required RTOR to control PTH, compared with 2.4% in 2022 (p < 0.0001). Use of codeine decreased from 6.9% in 2008 to 2.5% in 2022 (p = 0.0022). Use of ibuprofen, acetaminophen, ketorolac, and oxycodone increased from 1.6% to 23.4% (p = 0.0005), 36.1% to 78.6% (p < 0.0001), 1.5% to 11.9% (p < 0.0001), and 20.6% to 63.6% (p < 0.0001), respectively. No change was detected in use of hydrocodone.
Post-tonsillectomy analgesia in adults has changed significantly over the last 15 years. Our study highlights a concurrent increase in PTH which bears more investigation.
3 Laryngoscope, 135:1958-1963, 2025.
在过去十年中，儿童扁桃体切除术后出血（PTH）率有所上升。本研究旨在确定在过去15年中，成人PTH的发生率是否也有所增加。
回顾性研究。
TriNetX数据库。
使用TriNetX在美国协作网络中对18岁及以上接受扁桃体切除术（CPT编码42821或42826）的患者进行搜索，共获得72232名受试者。使用ICD-10编码J95.830或K91.840确定PTH诊断，并使用CPT 42962确定返回手术室（RTOR）以控制PTH的患者。从2008年到2022年，每年统计扁桃体切除术后14天内发生的PTH事件和给予的镇痛药。使用Mann-Kendall单调趋势检验来检查PTH和镇痛药使用的显著趋势。
扁桃体切除术的平均年龄为32.8岁（标准差=13.8）。2008年，4.1%的患者被诊断为PTH，到2022年这一比例为6.2%（p=0.0030）。2008年，0.7%的患者需要RTOR来控制PTH，2022年这一比例为2.4%（p<0.0001）。可待因的使用从2008年的6.9%降至2022年的2.5%（p=0.0022）。布洛芬、对乙酰氨基酚、酮咯酸和羟考酮的使用分别从1.6%增加到23.4%（p=0.0005）、36.1%增加到78.6%（p<0.0001）、1.5%增加到11.9%（p<0.0001）和20.6%增加到63.6%（p<0.0001）。氢可酮的使用未发现变化。
在过去15年中，成人扁桃体切除术后镇痛发生了显著变化。我们的研究强调了PTH的同时增加，这值得进一步研究。
3 喉镜，135:1958 - 1963，2025年。
