Harrison W Lin1, Neil Bhattacharyya. 1. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02214, USA. harrison_lin@meei.harvard.edu
Abstract
OBJECTIVE: To update the incidence of medical morbidity and mortality in head and neck surgery and factors that influence length of stay (LOS). STUDY DESIGN: Cross-sectional analysis of a national database. SETTING: Academic medical center. METHODS: A specific database for head and neck surgical procedures was extracted from the National Hospital Data Survey for 2005 through 2007. Records of inpatient admissions for patients undergoing head and neck surgery as the primary procedure were examined to establish the frequency of medical complications, mortality, and LOS. The association of these medical complications with mortality and LOS was determined. RESULTS: A total of 330,629 head and neck procedures were analyzed. The overall medical morbidity and mortality rates were 5.0% ± 0.7% and 0.4% ± 0.2%, respectively. The most common medical complication was hospital-acquired pneumonia (3.3% ± 0.6%), whereas acute renal failure, stroke, acute myocardial infarction, pulmonary embolism, and deep venous thrombosis were substantially less frequent (combined incidence, 2.1%). The mean LOS for patients without a major complication was 3.3 ± 0.2 days vs 14.0 ± 1.9 days for those with a major complication (P < .001). CONCLUSIONS: Medical morbidity and mortality in patients undergoing head and neck surgical procedures continue to be exceedingly low. Although medical complications are associated with a longer LOS, the influence of medical complications on mortality has declined. Enhancements in perioperative medical management of head and neck surgical patients are likely responsible for these improved results.
OBJECTIVE: To update the incidence of medical morbidity and mortality in head and neck surgery and factors that influence length of stay (LOS). STUDY DESIGN: Cross-sectional analysis of a national database. SETTING: Academic medical center. METHODS: A specific database for head and neck surgical procedures was extracted from the National Hospital Data Survey for 2005 through 2007. Records of inpatient admissions for patients undergoing head and neck surgery as the primary procedure were examined to establish the frequency of medical complications, mortality, and LOS. The association of these medical complications with mortality and LOS was determined. RESULTS: A total of 330,629 head and neck procedures were analyzed. The overall medical morbidity and mortality rates were 5.0% ± 0.7% and 0.4% ± 0.2%, respectively. The most common medical complication was hospital-acquired pneumonia (3.3% ± 0.6%), whereas acute renal failure, stroke, acute myocardial infarction, pulmonary embolism, and deep venous thrombosis were substantially less frequent (combined incidence, 2.1%). The mean LOS for patients without a major complication was 3.3 ± 0.2 days vs 14.0 ± 1.9 days for those with a major complication (P < .001). CONCLUSIONS: Medical morbidity and mortality in patients undergoing head and neck surgical procedures continue to be exceedingly low. Although medical complications are associated with a longer LOS, the influence of medical complications on mortality has declined. Enhancements in perioperative medical management of head and neck surgical patients are likely responsible for these improved results.