• Greg R Licameli, Dwight T Jones, Jodi Santosuosso, Catherine Lapp, Carlo Brugnara, and Margaret A Kenna.
• Department of Otolaryngology and Communication Enhancement, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. Greg.licameli@childrens.harvard.edu
• Otolaryngol Head Neck Surg. 2008 Oct 1;139(4):546-550.

ObjectiveTo determine the efficacy of a preoperative bleeding questionnaire (POBQ) and coagulation screening in predicting hemorrhage associated with adenotonsillectomy.Study DesignRetrospective study.Subjects And MethodsBetween January 1998 and December 2003, 7730 tonsillectomy and adenotonsillectomy patients were administered the POBQ preoperatively. Further coagulation screening was based on POBQ responses.ResultsA total of 232 (3.0%) of 7730 had postoperative bleeding; 184 (3.2%) of 5782 patients who had negative questionnaires bled postoperatively compared with 48 (2.5%) of 1948 patients with positive questionnaires (P = 0.126). Of 1948 patients with positive questionnaires, 141 (7.2%) had abnormal preoperative coagulation screens and 9 (6.4%) of 141 bled; of the 1807 (92.8%) with negative coagulation screens, 39 (2.2%) bled (P = 0.005).ConclusionThe POBQ is an effective tool for identifying patients who are at potential risk for post-tonsillectomy bleeding. Patients with both a positive POBQ and coagulation screen had a statistically higher likelihood of postoperative bleeding than other patients. The POBQ allowed the identification of individuals with bleeding disorders to be treated before surgery, likely decreasing the risk of bleeding in these patients.

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