Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 3/2015

01-03-2015 | Miscellaneous

Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden

Authors: Eirik Østvoll, Ola Sunnergren, Elisabeth Ericsson, Claes Hemlin, Elisabeth Hultcrantz, Erik Odhagen, Joacim Stalfors

Published in: European Archives of Oto-Rhino-Laryngology | Issue 3/2015

Login to get access

Abstract

The objective of this retrospective cohort study was to evaluate mortality rate and cause of death after tonsil surgery in Sweden. Two national registries were used, both run by The Swedish National Board of Health and Welfare, an agency of the Ministry of Health and Social Affairs. In the National Patient register all tonsil surgeries performed in Sweden from 2004 through 2011 were identified. The result from this search was matched with the National Cause of Death Register to identify all deaths that occurred within 30 days of tonsil surgery. Personal identity numbers were used to do the matching of registers. Details on the cause of death were obtained from the Swedish National Board of Health and Welfare. Two deaths were identified in 82,527 operations. Both patients were male, otherwise healthy, children under the age of five, operated due to tonsil-related upper airway obstruction/snoring with coblation technique. Cause of death was bleeding-related airway obstruction in both cases and hemodynamic failure caused by blood loss. Both deaths occurred after discharge from the hospital within the first postoperative week. No abnormal levels of analgesics were found in the postmortal investigations. Two deaths related to tonsil surgery (performed on benign indications) were identified in 82,527 operations (2004–2011) in a well-defined national population. Both deaths were due to postoperative bleeding. Based on our findings, the frequency of post-tonsil-surgery mortality in Sweden was 1/41,263, 2004–2011.
Level of evidence 2b retrospective cohort study.
Literature
1.
go back to reference Goldman JL, Baugh RF, Davies L et al (2013) Mortality and major morbidity after tonsillectomy: etiologic factors and strategies for prevention. Laryngoscope 123(10):2544–2553PubMed Goldman JL, Baugh RF, Davies L et al (2013) Mortality and major morbidity after tonsillectomy: etiologic factors and strategies for prevention. Laryngoscope 123(10):2544–2553PubMed
3.
4.
go back to reference Windfuhr JP, Chen YS, Remmert S (2005) Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 132(2):281–286CrossRefPubMed Windfuhr JP, Chen YS, Remmert S (2005) Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 132(2):281–286CrossRefPubMed
5.
go back to reference Rasmussen N (1987) Complications of tonsillectomy and adenoidectomy. Otolaryngol Clin N Am 20(2):383–390 Rasmussen N (1987) Complications of tonsillectomy and adenoidectomy. Otolaryngol Clin N Am 20(2):383–390
6.
go back to reference Randall DA, Hoffer ME (1998) Complications of tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg 118(1):61–68CrossRefPubMed Randall DA, Hoffer ME (1998) Complications of tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg 118(1):61–68CrossRefPubMed
7.
go back to reference Windfuhr JP, Wienke A, Chen YS (2009) Electrosurgery as a risk factor for secondary post-tonsillectomy hemorrhage. Eur Arch Otorhinolaryngol 266:111–116CrossRefPubMed Windfuhr JP, Wienke A, Chen YS (2009) Electrosurgery as a risk factor for secondary post-tonsillectomy hemorrhage. Eur Arch Otorhinolaryngol 266:111–116CrossRefPubMed
8.
go back to reference Cote CJ, Posner KL, Domino KB (2014) Death or neurologic injury after tonsillectomy in children with a focus on obstructive sleep apnea: Houston, we have a problem! Anesth Analg 118(6):1276–1283CrossRefPubMed Cote CJ, Posner KL, Domino KB (2014) Death or neurologic injury after tonsillectomy in children with a focus on obstructive sleep apnea: Houston, we have a problem! Anesth Analg 118(6):1276–1283CrossRefPubMed
9.
go back to reference Peeters A, Claes J, Saldien V (2001) Lethal complications after tonsillectomy. Acta Otorhinolaryngol Belg 55(3):207–213PubMed Peeters A, Claes J, Saldien V (2001) Lethal complications after tonsillectomy. Acta Otorhinolaryngol Belg 55(3):207–213PubMed
13.
go back to reference Davies DD (1964) Anaesthetic mortality in tonsillectomy and adenoidectomy. Br J Anaesth 36:110–114CrossRefPubMed Davies DD (1964) Anaesthetic mortality in tonsillectomy and adenoidectomy. Br J Anaesth 36:110–114CrossRefPubMed
14.
go back to reference Stevenson AN, Myer CM 3rd, Shuler MD, Singer PS (2012) Complications and legal outcomes of tonsillectomy malpractice claims. Laryngoscope 122(1):71–74CrossRefPubMed Stevenson AN, Myer CM 3rd, Shuler MD, Singer PS (2012) Complications and legal outcomes of tonsillectomy malpractice claims. Laryngoscope 122(1):71–74CrossRefPubMed
15.
go back to reference Pratt LW (1970) Tonsillectomy and adenoidectomy: mortality and morbidity. Trans Am Acad Ophthalmol Otolaryngol 74(6):1146–1154PubMed Pratt LW (1970) Tonsillectomy and adenoidectomy: mortality and morbidity. Trans Am Acad Ophthalmol Otolaryngol 74(6):1146–1154PubMed
16.
go back to reference Pratt LW, Gallagher RA (1979) Tonsillectomy and adenoidectomy: incidence and mortality, 1968–1972. Otolaryngol Head Neck Surg 87(2):159–166PubMed Pratt LW, Gallagher RA (1979) Tonsillectomy and adenoidectomy: incidence and mortality, 1968–1972. Otolaryngol Head Neck Surg 87(2):159–166PubMed
17.
go back to reference Hessen Soderman AC, Ericsson E, Hemlin C et al (2011) Reduced risk of primary postoperative hemorrhage after tonsil surgery in Sweden: results from the National Tonsil Surgery Register in Sweden covering more than 10 years and 54,696 operations. Laryngoscope 121(11):2322–2326CrossRefPubMed Hessen Soderman AC, Ericsson E, Hemlin C et al (2011) Reduced risk of primary postoperative hemorrhage after tonsil surgery in Sweden: results from the National Tonsil Surgery Register in Sweden covering more than 10 years and 54,696 operations. Laryngoscope 121(11):2322–2326CrossRefPubMed
18.
go back to reference Carmody D, Vamadevan T, Cooper SM (1982) Post tonsillectomy haemorrhage. J Laryngol Otol 96(7):635–638CrossRefPubMed Carmody D, Vamadevan T, Cooper SM (1982) Post tonsillectomy haemorrhage. J Laryngol Otol 96(7):635–638CrossRefPubMed
19.
go back to reference Gysin C, Dulguerov P (2013) Hemorrhage after tonsillectomy: does the surgical technique really matter? ORL J Otorhinolaryngol Relat Spec 75(3):123–132CrossRefPubMed Gysin C, Dulguerov P (2013) Hemorrhage after tonsillectomy: does the surgical technique really matter? ORL J Otorhinolaryngol Relat Spec 75(3):123–132CrossRefPubMed
20.
go back to reference Windfuhr JP, Schloendorff G, Baburi D, Kremer B (2008) Lethal outcome of post-tonsillectomy hemorrhage. Eur Arch Otorhinolaryngol 265(12):1527–1534CrossRefPubMed Windfuhr JP, Schloendorff G, Baburi D, Kremer B (2008) Lethal outcome of post-tonsillectomy hemorrhage. Eur Arch Otorhinolaryngol 265(12):1527–1534CrossRefPubMed
21.
go back to reference Kelly LE, Rieder M, van den Anker J et al (2012) More codeine fatalities after tonsillectomy in North American children. Pediatrics 129(5):e1343–e1347CrossRefPubMed Kelly LE, Rieder M, van den Anker J et al (2012) More codeine fatalities after tonsillectomy in North American children. Pediatrics 129(5):e1343–e1347CrossRefPubMed
22.
go back to reference Riggin L, Ramakrishna J, Sommer DD, Koren G (2013) A 2013 updated systematic review & meta-analysis of 36 randomized controlled trials; no apparent effects of non steroidal anti-inflammatory agents on the risk of bleeding after tonsillectomy. Clin Otolaryngol 38(2):115–129CrossRefPubMed Riggin L, Ramakrishna J, Sommer DD, Koren G (2013) A 2013 updated systematic review & meta-analysis of 36 randomized controlled trials; no apparent effects of non steroidal anti-inflammatory agents on the risk of bleeding after tonsillectomy. Clin Otolaryngol 38(2):115–129CrossRefPubMed
25.
go back to reference Lowe D, van der Meulen J (2004) National prospective tonsillectomy audit. Tonsillectomy technique as a risk factor for postoperative haemorrhage. Lancet 364(9435):697–702CrossRefPubMed Lowe D, van der Meulen J (2004) National prospective tonsillectomy audit. Tonsillectomy technique as a risk factor for postoperative haemorrhage. Lancet 364(9435):697–702CrossRefPubMed
26.
go back to reference Sarny S, Ossimitz G, Habermann W, Stammberger H (2013) Austrian tonsil study part 3: surgical technique and postoperative haemorrhage after tonsillectomy. Laryngorhinootologie 92(2):92–96PubMed Sarny S, Ossimitz G, Habermann W, Stammberger H (2013) Austrian tonsil study part 3: surgical technique and postoperative haemorrhage after tonsillectomy. Laryngorhinootologie 92(2):92–96PubMed
27.
go back to reference Mathew R, Asimacopoulos E, Walker D, Gutierrez T, Valentine P, Pitkin L (2012) Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010. Ann Otol Rhinol Laryngol 121(5):337–340CrossRefPubMed Mathew R, Asimacopoulos E, Walker D, Gutierrez T, Valentine P, Pitkin L (2012) Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010. Ann Otol Rhinol Laryngol 121(5):337–340CrossRefPubMed
28.
go back to reference Pinder DK, Wilson H, Hilton MP (2011) Dissection versus diathermy for tonsillectomy. The Cochrane Database Syst Rev (3): CD002211 Pinder DK, Wilson H, Hilton MP (2011) Dissection versus diathermy for tonsillectomy. The Cochrane Database Syst Rev (3): CD002211
29.
go back to reference Hultcrantz E, Ericsson E (2013) Factors influencing the indication for tonsillectomy: a historical overview and current concepts. ORL J Otorhinolaryngol Relat Spec 75(3):184–191CrossRefPubMed Hultcrantz E, Ericsson E (2013) Factors influencing the indication for tonsillectomy: a historical overview and current concepts. ORL J Otorhinolaryngol Relat Spec 75(3):184–191CrossRefPubMed
30.
go back to reference Sarny S, Habermann W, Ossimitz G, Stammberger H (2013) What lessons can be learned from the Austrian events? ORL J Otorhinolaryngol Relat Spec 75(3):175–181CrossRefPubMed Sarny S, Habermann W, Ossimitz G, Stammberger H (2013) What lessons can be learned from the Austrian events? ORL J Otorhinolaryngol Relat Spec 75(3):175–181CrossRefPubMed
31.
go back to reference Majholm B, Engbaek J, Bartholdy J et al (2012) Is day surgery safe? A Danish multicentre study of morbidity after 57,709 day surgery procedures. Acta Anaesthesiol Scand 56(3):323–331CrossRefPubMed Majholm B, Engbaek J, Bartholdy J et al (2012) Is day surgery safe? A Danish multicentre study of morbidity after 57,709 day surgery procedures. Acta Anaesthesiol Scand 56(3):323–331CrossRefPubMed
32.
go back to reference Bennett AM, Clark AB, Bath AP, Montgomery PQ (2005) Meta-analysis of the timing of haemorrhage after tonsillectomy: an important factor in determining the safety of performing tonsillectomy as a day case procedure. Clin Otolaryngol 30(5):418–423CrossRefPubMed Bennett AM, Clark AB, Bath AP, Montgomery PQ (2005) Meta-analysis of the timing of haemorrhage after tonsillectomy: an important factor in determining the safety of performing tonsillectomy as a day case procedure. Clin Otolaryngol 30(5):418–423CrossRefPubMed
33.
go back to reference Sarny S, Ossimitz G, Habermann W, Stammberger H (2012) The Austrian tonsil study 2010–part 1: statistical overview. Laryngorhinootologie 91(1):16–21CrossRefPubMed Sarny S, Ossimitz G, Habermann W, Stammberger H (2012) The Austrian tonsil study 2010–part 1: statistical overview. Laryngorhinootologie 91(1):16–21CrossRefPubMed
34.
go back to reference Sarny S, Habermann W, Ossimitz G, Stammberger H (2012) The Austrian Tonsil Study 2010—Part 2: postoperative haemorrhage. Laryngorhinootologie 91(2):98–102CrossRefPubMed Sarny S, Habermann W, Ossimitz G, Stammberger H (2012) The Austrian Tonsil Study 2010—Part 2: postoperative haemorrhage. Laryngorhinootologie 91(2):98–102CrossRefPubMed
35.
go back to reference Tolska HK, Takala A, Pitkaniemi J, Jero J (2013) Post-tonsillectomy haemorrhage more common than previously described–an institutional chart review. Acta Otolaryngol 133(2):181–186CrossRefPubMed Tolska HK, Takala A, Pitkaniemi J, Jero J (2013) Post-tonsillectomy haemorrhage more common than previously described–an institutional chart review. Acta Otolaryngol 133(2):181–186CrossRefPubMed
Metadata
Title
Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden
Authors
Eirik Østvoll
Ola Sunnergren
Elisabeth Ericsson
Claes Hemlin
Elisabeth Hultcrantz
Erik Odhagen
Joacim Stalfors
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 3/2015
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-014-3312-z

Other articles of this Issue 3/2015

European Archives of Oto-Rhino-Laryngology 3/2015 Go to the issue