{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T23:28:54Z","timestamp":1781047734983,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["World j. otorhinolaryngol.-head neck surg."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A significant complication of pediatric tonsillectomy is post\u2010tonsillectomy bleeding (PTB). Management within and outside of the operating room (OR) is not standardized. We consolidated international similarities and differences in PTB management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional survey study was conducted from April 4 to May 16, 2024. It involved a 55\u2010item questionnaire distributed online to a sample of pediatric otolaryngologists from 22 countries, and is a part of larger study on tonsillectomy. The study achieved a 38.2% response rate (112 of 293). Eligibility included proficiency in English and currently practicing pediatric otolaryngology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A tonsil bleed was defined by 49.2% as any bleeding presenting to the hospital. In all, 58.3% signified taking patients for operative management in the presence of active bleeding. Operative criteria included persistent bleeding on presentation, repeated bleeding while admitted, severity, signs\/symptoms of anemia or hemodynamic instability, or age less than 3 and non\u2010cooperative. When treating PTB within the OR, bipolar cautery is used by 60.6%. In all, 57.3% admit all patients experiencing a PTB for 23\u2010h observation versus 21.2% who admit a subset of patients for 23\u2010h observation. In all, 47.7% indicated that they have a formal monitoring program for bleeding rates in their institution\/practice. Readmission rates are monitored by 60.7% of respondents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There are no standardized best practices for PTB. Our study confirmed moderate numbers of formal monitoring programs, and varying clinical decision rules when defining a tonsil bleed, readmitting a PTB, and management within or outside of the OR. Understanding global variation may facilitate development of future clinical practice guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjo2.70068","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T06:25:47Z","timestamp":1761287147000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["International Practice Variation in Post\u2010Tonsillectomy Hemorrhage: A Survey Study of Pediatric Otolaryngologists"],"prefix":"10.1002","author":[{"given":"Gina M.","family":"Spencer","sequence":"first","affiliation":[{"name":"Queen's University School of Medicine Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire A.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Davidson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie E.","family":"Strychowsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire M.","family":"Lawlor","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Queensland Children's Hospital University of Queensland Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eishaan K.","family":"Bhargava","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Sheffield Children's Hospital Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7159-2953","authenticated-orcid":false,"given":"M. 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