Predicting post-tonsillectomy hemorrhage risk using neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet count, and MPV

Tonsillectomy is one of the most frequently performed surgeries in otolaryngology, with postoperative hemorrhage being its most important complication. In this study, the relationship between postoperative bleeding and hematologic inflammatory markers was retrospectively investigated after adult tonsillectomy. Between January 2019 and April 2025, 100 adult patients who underwent tonsillectomy at the Otolaryngology Clinic of Akdeniz University Faculty of Medicine were included (50 developed postoperative bleeding, 50 with no bleeding). Demographic data, clinical characteristics, and preoperative laboratory parameters (NLR, PLR, MPV, platelet count, SII, and SIRI) were analyzed. Statistical analyses were performed using IBM SPSS Statistics 25. Normality was assessed with the Kolmogorov-Smirnov test; intergroup differences were evaluated with independent samples t-test, Mann-Whitney U test, and chi-square test. Results showed no statistically significant association between postoperative hemorrhage and NLR, PLR, or MPV; however, male sex and tobacco use appeared to be independent risk factors. Our study indicates that NLR, PLR, and MPV alone are not sufficient to predict postoperative bleeding after tonsillectomy, and they should be considered alongside clinical and demographic factors in risk assessment. The findings support the potential contribution of biomarkers in predicting postoperative complications in adults after tonsillectomy and highlight the need for larger-scale studies.