(237) Vaping as a Risk Factor for Postoperative Bleeding After Tonsillectomy

Introduction: Tonsillectomy carries a known risk of postoperative bleeding, and the increasing prevalence of vaping raises concern for its potential impact on bleeding risk. This study aims to evaluate the association between vaping and post-tonsillectomy bleeding.

Methods: A retrospective cohort study using the TriNetX Research Network was performed to evaluate postoperative hemorrhage risk in adults undergoing tonsillectomy ± adenoidectomy for tonsillitis, stratified by vaping history and 1:1 propensity score matched by age, sex, race, and ethnicity. Patients were identified using CPT, ICD-10-PCS, and SNOMED procedure codes, with the procedure date serving as the index event. All patients were required to have a documented diagnosis of tonsillitis before the index procedure. Patients with a diagnosis of head and neck malignancy at any time were excluded. The primary outcome was post-tonsillectomy bleeding with or without procedural control occurring within 1 month of surgery.

Results: 2,021 adults undergoing tonsillectomy ± adenoidectomy for tonsillitis met inclusion criteria. The non-vaping cohort included 1,010 patients, and the vaping cohort included 1,011 patients. Mean age after matching was 26 years and patients were predominantly female (68%) and white (77%).

Within 1 month of tonsillectomy, postoperative bleeding occurred in 36 patients (3.6%) in the non-vaping cohort and 59 patients (5.8%) in the vaping cohort. Patients with a history of vaping had significantly increased odds of postoperative bleeding (OR 1.67, 95% CI 1.09–2.55, p=.016).

Conclusions: The association between vaping and increased bleeding risk highlights the importance of screening for vaping in surgical candidates and reinforces the need for targeted perioperative counseling to reduce preventable complications.