Zaid Al-Qurayshi1, Gregory Randolph2,3, Jarrett Walsh1, Scott Owen1, Emad Kandil4. 1. Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa. 2. Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts. 3. Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear Infirmary, Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts. 4. Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: To examine the risk and prevalence of accidental intraoperative injury reported during head and neck surgeries and the associated outcomes. STUDY DESIGN: Retrospective cross-sectional analysis. METHODS: An analysis utilizing the Nationwide Readmissions Database, 2010 to 2014. Adult patients with a reported accidental intraoperative injury were compared to controls without such injuries. RESULTS: A total of 173 cases and 105,659 controls were included. Most cases were reported in surgeries of the mouth/tonsils (29.4%) and maxillofacial bones/mandible (22.5%). The remaining cases were reported in surgeries of the pharynx/larynx (17.5%), nose/paranasal sinuses (15.4%), salivary glands and ducts (6.2%), thyroid/parathyroid (5.2%), and ear (3.8%). The multivariate logistic regression model demonstrated that surgeries of the pharynx/larynx were associated with the highest risk of injuries compared to other site surgeries (odds ratio [OR]: 2.51, 95% confidence interval [CI]: 1.49, 4.25, P < .001]. Concomitant neck dissection was also independently associated with the risk of injury (OR: 4.07, 95% CI: 2.05, 8.09, P < .001]. Compared to controls, cases were not associated with an increased risk of mortality (P = .63) or readmission (P = .29); however, those cases had a significantly longer hospital stay on average by 3.64 ± 0.95 days/case (P < .001) and a higher cost of treatment on average by $13,478 ± 119.42/case (P < .001). CONCLUSIONS: This study reports on the prevalence and outcomes of accidental intraoperative injuries reported in head and neck surgeries. The prevalence is relatively low, and the annual trend appears stable; however, it is associated with a significant burden on the health system. LEVEL OF EVIDENCE: NA Laryngoscope, 130:918-924, 2020.
OBJECTIVES/HYPOTHESIS: To examine the risk and prevalence of accidental intraoperative injury reported during head and neck surgeries and the associated outcomes. STUDY DESIGN: Retrospective cross-sectional analysis. METHODS: An analysis utilizing the Nationwide Readmissions Database, 2010 to 2014. Adult patients with a reported accidental intraoperative injury were compared to controls without such injuries. RESULTS: A total of 173 cases and 105,659 controls were included. Most cases were reported in surgeries of the mouth/tonsils (29.4%) and maxillofacial bones/mandible (22.5%). The remaining cases were reported in surgeries of the pharynx/larynx (17.5%), nose/paranasal sinuses (15.4%), salivary glands and ducts (6.2%), thyroid/parathyroid (5.2%), and ear (3.8%). The multivariate logistic regression model demonstrated that surgeries of the pharynx/larynx were associated with the highest risk of injuries compared to other site surgeries (odds ratio [OR]: 2.51, 95% confidence interval [CI]: 1.49, 4.25, P < .001]. Concomitant neck dissection was also independently associated with the risk of injury (OR: 4.07, 95% CI: 2.05, 8.09, P < .001]. Compared to controls, cases were not associated with an increased risk of mortality (P = .63) or readmission (P = .29); however, those cases had a significantly longer hospital stay on average by 3.64 ± 0.95 days/case (P < .001) and a higher cost of treatment on average by $13,478 ± 119.42/case (P < .001). CONCLUSIONS: This study reports on the prevalence and outcomes of accidental intraoperative injuries reported in head and neck surgeries. The prevalence is relatively low, and the annual trend appears stable; however, it is associated with a significant burden on the health system. LEVEL OF EVIDENCE: NA Laryngoscope, 130:918-924, 2020.
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