The post-operative tonsillectomy (POPT) study: A multi-centre prospective paediatric cohort study

Abstract

Objectives: Tonsillectomy is the most common operation performed by otolaryngologists in the UK, despite this we have a poor understanding of the post-operative recovery. We aimed to investigate post-operative bleeding and pain following paediatric tonsillectomy using a patient diary. Design: Prospective observational cohort study. Setting: Multi-centre study involving 12 secondary and tertiary otolaryngology units across the North of England. Patients were recruited from 1st March 2020 to 30th June 2022. Multilevel ordered logistic regression model statistics were performed. Participants: Children (≥4 years, ≤16 years) undergoing tonsillectomy (with or without adenoidectomy) for benign pathology. Main Outcome Measures: Frequency and severity of post-operative bleeding. Intensity and pattern of post-operative pain. Results: In total 297 children were recruited, with 91 (30.6%) diaries eligible for analysis. Post-operative bleeding occurred in 44% of children. Most frequently blood in the saliva was reported (82.9%). Increasing age significantly increased bleeding odds by 17% per year (p =.001). Bleeding frequency decreased with higher surgeon grade (p =.003) and when performing intracapsular coblation tonsillectomy (p =.02) compared with other techniques. Lower age and intracapsular coblation tonsillectomy, against other techniques, significantly reduced rates of pain post-operatively (p