Incidence and predictors of post-tonsillectomy hemorrhage: a two-year retrospective analysis from a tertiary care center in Qatar

Abstract

Background: Post-tonsillectomy bleeding (PTB) is one of the most concerning complications following tonsillectomy, with potential implications for patient morbidity and surgical outcomes. This retrospective study aimed to determine the incidence, pattern, and possible demographic risk factors associated with PTB in a tertiary care hospital setting.

Methods: A retrospective review was conducted at Al Ahli Hospital, Doha, Qatar, including 329 patients who underwent tonsillectomy between September 2023 and August 2025. Patients with recurrent chronic tonsillitis or obstructive sleep apnea were included, while those with unilateral tonsillectomy, tonsillar biopsy, or suspected neoplasms were excluded. Data on demographic characteristics, timing of bleeding, and return to the operating room (OR) were analyzed using Fisher’s Exact Test, with p<0.05 considered statistically significant.

Results: The overall incidence of PTB was 4.25%, comprising 0.30% primary and 3.95% secondary hemorrhage. Bleeding was more frequent in males (3.34%) compared to females (0.91%), and a slight increase in bleeding incidence was noted with age (0.91% in <5 years, 1.51% in 5–15 years, and 1.82% in ≥16 years). However, these differences were not statistically significant. Only 1.21% of patients required surgical intervention, and no cases required blood transfusion. Bilateral and contralateral bleeding were rare (0.30% each).

Conclusion: PTB incidence in this cohort was low and predominantly secondary in nature. Although bleeding was more frequent among older and male patients, neither age nor gender significantly influenced the risk of reoperation. Consistent surgical technique and vigilant postoperative monitoring remain critical for minimizing bleeding-related complications.