Journal article
A national overview of surgical misadventures in head and neck surgery: "Oh No, You Cut It"
The Laryngoscope, Vol.130(4), pp.918-924
04/01/2020
DOI: 10.1002/lary.28035
PMCID: PMC6834862
PMID: 31063587
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
Details
- Title: Subtitle
- A national overview of surgical misadventures in head and neck surgery: "Oh No, You Cut It"
- Creators
- Zaid Al-Qurayshi - University of Iowa Hospitals and ClinicsGregory Randolph - Harvard UniversityJarrett Walsh - University of Iowa Hospitals and ClinicsScott Owen - University of Iowa Hospitals and ClinicsEmad Kandil - Tulane University
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.130(4), pp.918-924
- DOI
- 10.1002/lary.28035
- PMID
- 31063587
- PMCID
- PMC6834862
- NLM abbreviation
- Laryngoscope
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- 2T32DC000040-21 / NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA T32 DC000040 / NIDCD NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD)
- Language
- English
- Date published
- 04/01/2020
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984311442402771
Metrics
12 Record Views