ABS TRACT Objective:To evaluate the relationship between the Systemic Immune-Inflammation Index (SII) and secondary post-tonsillectomy hemorrhage (PTH) in adults undergoing surgery for recurrent tonsillitis.Material and Methods: Medical records of 287 adults who underwent tonsillectomy were reviewed.Demographic and surgical variables, including preoperative hemoglobin (Hb), platelet, lymphocyte, and neutrophil counts, as well as derived indices, including SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), were analyzed.In patients with hemorrhage, laboratory values on the bleeding day were compared with preoperative data.Results: The overall PTH rate was 17.8%, with 4.9% requiring surgical intervention.Most bleeding episodes occurred between postoperative days 5-12.No significant associations were found between PTH and sex, smoking status, season, or tonsil grade, though recurrent hemorrhage was more frequent in males.Preoperative SII, PLR, and NLR values did not differ significantly between patients with and without PTH (all p>0.05).On the bleeding day, Hb and lymphocyte counts decreased, whereas neutrophil counts increased, leading to significant increases in SII, NLR, and PLR (all p<0.05).Both conservatively and surgically managed PTH groups exhibited similar inflammatory responses, except for a non-significant PLR elevation in the surgical subgroup.Conclusion: SII and related indices were considered potentially useful for evaluating the inflammatory process observed on the day of bleeding among adult patients undergoing tonsillectomy for recurrent tonsillitis; however, they do not constitute a valid tool for preoperative risk assessment of secondary PTH.
Günay et al. (2026) studied this question.