Khodayar Goshtasbi1, Mehdi Abouzari1, Sina Soltanzadeh-Zarandi1, Brooke Sarna1, Ariel Lee1, Frank P K Hsu2, Hamid R Djalilian3. 1. Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA. 2. Department of Neurological Surgery, University of California, Irvine, USA. 3. Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA; Department of Biomedical Engineering, University of California, Irvine, USA. Electronic address: hdjalili@hs.uci.edu.
Abstract
OBJECTIVE: To evaluate whether increased body mass index (BMI), age, or frailty influence vestibular schwannoma (VS) short-term surgical morbidity. METHODS: The 2005-2017 National Surgical Quality Improvement Program database was queried for patients with VS undergoing surgical resection. Age was stratified according to age <50, 50-64, and ≥65, while BMI was stratified based on a threshold of 30. Frailty score (0-5) was indicated based on functional status, diabetes, chronic obstructive pulmonary disease, congestive heart failure, and hypertension. RESULTS: A total of 1405 patients were included consisting of 56.7 % females with a mean age of 50.7 ± 13.8 years and mean BMI of 29.4 ± 6.6. Patients <50 (n = 604), 50-64 (n = 578), and ≥65 (n = 223), had different duration of surgery (428 ± 173 vs. 392 ± 149 vs. 387 ± 154 min; p < 0.001) and 30-day mortality rates (0.7 % vs. 0% vs. 1.8 %; p = 0.01). However, post-operative length of stay (LOS) (p = 0.16), readmission (p = 0.08), reoperation (p = 0.54), and complication rates were similar. Post-operative myocardial infarction (p = 0.03) and wound infection (p = 0.02) were more commonly observed in the obese cohort (BMI≥30) but readmission (p = 0.18), reoperation (p = 0.44), and complication rates were similar to those with BMI<30. Severely obese patients (BMI≥35) also had higher rates of deep vein thrombosis (p = 0.004). Frailty score 0 (n=921), 1 (n=375), and 2-4 (n=109) was associated with LOS (4.7±3.5 vs. 5.3 ± 4.1 vs. 6.7 ± 6.6 days, p < 0.001) and prolonged intubation rates (1.0 % vs. 2.4 % vs. 3.7 %; p = 0.03). CONCLUSIONS: Increased age, BMI, and frailty among VS patients were associated with different post-operative complication rates, operation time, or LOS. Knowledge of these can optimize care for at-risk patients.
OBJECTIVE: To evaluate whether increased body mass index (BMI), age, or frailty influence vestibular schwannoma (VS) short-term surgical morbidity. METHODS: The 2005-2017 National Surgical Quality Improvement Program database was queried for patients with VS undergoing surgical resection. Age was stratified according to age <50, 50-64, and ≥65, while BMI was stratified based on a threshold of 30. Frailty score (0-5) was indicated based on functional status, diabetes, chronic obstructive pulmonary disease, congestive heart failure, and hypertension. RESULTS: A total of 1405 patients were included consisting of 56.7 % females with a mean age of 50.7 ± 13.8 years and mean BMI of 29.4 ± 6.6. Patients <50 (n = 604), 50-64 (n = 578), and ≥65 (n = 223), had different duration of surgery (428 ± 173 vs. 392 ± 149 vs. 387 ± 154 min; p < 0.001) and 30-day mortality rates (0.7 % vs. 0% vs. 1.8 %; p = 0.01). However, post-operative length of stay (LOS) (p = 0.16), readmission (p = 0.08), reoperation (p = 0.54), and complication rates were similar. Post-operative myocardial infarction (p = 0.03) and wound infection (p = 0.02) were more commonly observed in the obese cohort (BMI≥30) but readmission (p = 0.18), reoperation (p = 0.44), and complication rates were similar to those with BMI<30. Severely obesepatients (BMI≥35) also had higher rates of deep vein thrombosis (p = 0.004). Frailty score 0 (n=921), 1 (n=375), and 2-4 (n=109) was associated with LOS (4.7±3.5 vs. 5.3 ± 4.1 vs. 6.7 ± 6.6 days, p < 0.001) and prolonged intubation rates (1.0 % vs. 2.4 % vs. 3.7 %; p = 0.03). CONCLUSIONS: Increased age, BMI, and frailty among VS patients were associated with different post-operative complication rates, operation time, or LOS. Knowledge of these can optimize care for at-risk patients.
Authors: Jaime L Bellamy; Robert P Runner; CatPhuong Cathy L Vu; Mara L Schenker; Thomas L Bradbury; James R Roberson Journal: J Arthroplasty Date: 2017-05-04 Impact factor: 4.757
Authors: Mohemmed N Khan; Jack Russo; John Spivack; Christopher Pool; Ilya Likhterov; Marita Teng; Eric M Genden; Brett A Miles Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-06-01 Impact factor: 6.223
Authors: Gabriel de la Garza; Oleg Militsakh; Aru Panwar; Tabitha L Galloway; Jeffrey B Jorgensen; Levi G Ledgerwood; Katelyn Kaiser; Collin Kitzerow; Yelizaveta Shnayder; Colin A Neumann; Samir S Khariwala; W Chad Spanos; Nitin A Pagedar Journal: Head Neck Date: 2015-08-13 Impact factor: 3.147
Authors: Alexander L Luryi; Seilesh Babu; Elias M Michaelides; John F Kveton; Dennis I Bojrab; Christopher A Schutt Journal: Otolaryngol Head Neck Surg Date: 2020-03-03 Impact factor: 3.497