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Predictors of Short-term Morbidity and Mortality in Open Anterior Skull Base Surgery.
- Source :
-
The Laryngoscope [Laryngoscope] 2019 Jun; Vol. 129 (6), pp. 1407-1412. Date of Electronic Publication: 2018 Oct 16. - Publication Year :
- 2019
-
Abstract
- Objectives/hypothesis: To describe rates of complications and mortality within 30 days of open anterior skull base surgery using a large, multi-institutional outcomes database.<br />Study Design: Retrospective cohort study.<br />Methods: The study included patients who underwent open anterior skull base surgery as listed in the American College of Surgeons National Surgical Quality Improvement Project database from 2007 through 2014.<br />Results: A total of 336 open anterior skull base surgeries were identified. One hundred nine (32.4%) patients experienced a complication, reoperation, or mortality. The most common events were postoperative transfusion (15.8%), reoperation (10.1%), and readmission (8.0%). Significant independent predictors of any adverse event included higher American Society of Anesthesiologists (ASA) score and increased total operative time (both P < .05). The only predictor of mortality was higher ASA score (P = .02). Predictors of increased hospital stay included impaired sensorium (P = .04), coma >24 hours (P < .001), lower preoperative hematocrit (P = .02), higher ASA score (P = .04), and increased total operative time (P < .001).<br />Conclusions: Open anterior skull base surgery is understandably complex, and is thus associated with a relatively high adverse event rate. Knowledge of factors associated with adverse events has the potential to improve preoperative optimization of controllable variables and translate into improved surgical outcomes for patients.<br />Level of Evidence: NA Laryngoscope, 129:1407-1412, 2019.<br /> (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Blood Transfusion statistics & numerical data
Female
Humans
Male
Middle Aged
Morbidity
Postoperative Complications etiology
Retrospective Studies
Risk Factors
Time Factors
Young Adult
Length of Stay statistics & numerical data
Patient Readmission statistics & numerical data
Postoperative Complications mortality
Reoperation statistics & numerical data
Skull Base surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1531-4995
- Volume :
- 129
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 30325512
- Full Text :
- https://doi.org/10.1002/lary.27494