Safety and Predictors of 30-Day Adverse Events of Laryngeal Framework Surgery: An Analysis of ACS-NSQIP data.
ACS-NSQIP
Laryngeal framework surgery
perioperative adverse events
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
revised:
22
09
2021
received:
06
07
2021
accepted:
15
10
2021
pubmed:
3
11
2021
medline:
18
6
2022
entrez:
2
11
2021
Statut:
ppublish
Résumé
To characterize and identify predictors of 30-day adverse events in patients undergoing laryngeal framework surgery (LFS). This study is a retrospective analysis of the National Surgical Quality Improvement dataset. LFS cases were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2008 to 2018. Demographic variables, patient comorbidities, and perioperative outcomes (any adverse event, 30-day readmission, 30-day reoperation, and unplanned intubation) were extracted. Patient-specific and surgery-specific factors associated with perioperative adverse events were examined using descriptive statistics and univariate logistic regression (LR). Of 283 patients who underwent LFS, 225 underwent laryngoplasty medialization, 56 underwent laryngoplasty medialization with arytenoidectomy or arytenoidopexy via an external approach, and 2 underwent local myocutaneous or fasciocutaneous advancement flap along with laryngoplasty. Medical comorbidities were present in 33.6% of patients and 57.9% were American Society of Anesthesiologists (ASA) Class III/IV (57.9%). LFS was performed as same-day surgery in 30.7% of cases. Fourteen patients (4.9%) suffered an adverse condition within 30 days following surgery. In univariate LR, ASA Class III or IV (odds ratio [OR] 4.6, 95% confidence interval [CI] 1.2-30.1) was the only predictor associated with any adverse event. Arytenoid adduction (AA) was associated with increased risk of reoperation within 30 days of the initial surgery (OR 6.4, 95% CI 1.0-49). LFS is a generally safe procedure with infrequent perioperative adverse events. In the ACS-NSQIP database, ASA classification of III or IV was associated with a higher risk for any 30-day adverse event and AA was associated with a higher risk for 30-day reoperation. 4 Laryngoscope, 132:1414-1420, 2022.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1414-1420Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
Références
Damrose EJ, Berke GS. Advances in the management of glottic insufficiency. Curr Opin Otolaryngol Head Neck Surg 2003;11: 480-484. https://journals.lww.com/co-otolaryngology/Fulltext/2003/12000/Advances_in_the_management_of_glottic.13.aspx.
Crumley RL. Selective reinnervation of vocal cord adductors in unilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 1984;93:351-356. https://doi.org/10.1177/000348948409300414.
Woodson GD. Commentary. Arch Otolaryngol Neck Surg 2010;136:829. https://doi.org/10.1001/archoto.2010.113.
Isshiki N, Morita H, Okamura H, Hiramoto M. Thyroplasty as a new phonosurgical technique. Acta Otolaryngol 1974;78:451-457. https://doi.org/10.3109/00016487409126379.
Zeitels SM, Mauri M, Dailey SH. Adduction arytenopexy for vocal fold paralysis: indications and technique. J Laryngol Otol 2004;118:508-516. https://doi.org/10.1258/0022215041615263.
Isshiki N, Tanabe M, Sawada M. Arytenoid adduction for unilateral vocal cord paralysis. Arch Otolaryngol 1978;104:555-558. https://doi.org/10.1001/archotol.1978.00790100009002.
Rosen CA. Complications of phonosurgery: results of a national survey. Laryngoscope 1998;108:1697-1703. https://doi.org/10.1097/00005537-199811000-00020.
Young VN, Zullo TG, Rosen CA. Analysis of laryngeal framework surgery: 10-year follow-up to a national survey. Laryngoscope 2010;120:1602-1608. https://doi.org/10.1002/lary.21004.
Weinman EC, Maragos NE. Airway compromise in thyroplasty surgery. Laryngoscope 2000;110:1082-1085. https://doi.org/10.1097/00005537-200007000-00003.
Tucker HM, Wanamaker J, Trott M, Hicks D. Complications of laryngeal framework surgery (phonosurgery). Laryngoscope 1993;103:525-528. https://doi.org/10.1288/00005537-199305000-00008.
Abraham MT, Gonen M, Kraus DH. Complications of type I thyroplasty and arytenoid adduction. Laryngoscope 2001;111:1322-1329. https://doi.org/10.1097/00005537-200108000-00003.
Chau SM, Kim CM, Vahabzadeh-Hagh A, Verma SP, Chhetri DK. Safety of outpatient unilateral medialization laryngoplasty across two academic institutions. Laryngoscope 2019;129:1647-1649. https://doi.org/10.1002/lary.27688.
Patel J, Boon M, Spiegel J, Huntley C. Safety of outpatient type 1 thyroplasty. Ear Nose Throat J 2020;100:608S-613S. https://doi.org/10.1177/0145561319894414.
Junlapan A, Sung CK, Damrose EJ. Type I thyroplasty: a safe outpatient procedure. Laryngoscope 2019;129:1640-1646. https://doi.org/10.1002/lary.27686.
Ingraham AM, Richards KE, Hall BL, Ko CY. Quality improvement in surgery: the American College of Surgeons National Surgical Quality Improvement Program Approach. Adv Surg 2010;44:251-267. https://doi.org/10.1016/j.yasu.2010.05.003.
ACS NSQIP. Available at: https://www.facs.org/~/media/files/qualityprograms/nsqip/nsqip_puf_userguide_2017.ashx. Accessed February 9, 2020.
Ekbom DC, Orbelo DM, Sangaralingham LR, Mwangi R, Van Houten HK, Balakrishnan K. Medialization laryngoplasty/arytenoid adduction: U.S. outcomes, discharge status, and utilization trends. Laryngoscope 2019;129:952-960. https://doi.org/10.1002/lary.27538.
Zhao X, Roth K, Fung K. Type I thyroplasty: risk stratification approach to inpatient versus outpatient postoperative management. J Otolaryngol - head neck Surg = Le J d'oto-rhino-laryngologie Chir cervico-faciale 2010;39:757-761.
Bray D, Young JP, Harries ML. Complications after type one thyroplasty: Is day-case surgery feasible? J Laryngol Otol 2008;122:715-718. https://doi.org/10.1017/S0022215108002144.
Grønkjaer M, Eliasen M, Skov-Ettrup LS, et al. Preoperative smoking status and postoperative complications: a systematic review and meta-analysis. Ann Surg 2014;259:52-71. https://journals.lww.com/annalsofsurgery/Fulltext/2014/01000/Preoperative_Smoking_Status_and_Postoperative.10.aspx.
Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status - historical perspectives and modern developments. Anaesthesia 2019;74:373-379. https://doi.org/10.1111/anae.14569.
Hackett NJ, De Oliveira GS, Jain UK, Kim JYS. ASA class is a reliable independent predictor of medical complications and mortality following surgery. Int J Surg 2015;18:184-190. https://doi.org/10.1016/j.ijsu.2015.04.079.
COTTER CS, AVIDANO MA, CRARY MA, CASSISI NJ, GORHAM MM. Laryngeal complications after type I thyroplasty. Otolaryngol - Head Neck Surg 1995;113:671-673. https://doi.org/10.1016/S0194-5998(95)70003-X.
McCulloch TM, Hoffman HT, Andrews BT, Karnell MP. Arytenoid adduction combined with Gore-Tex medialization thyroplasty. Laryngoscope 2000;110:1306-1311. https://doi.org/10.1097/00005537-200008000-00015.
Nouwen J, Hans S, De Mones E, Brasnu D, Crevier-Buchman L, Laccourreye O. Thyroplasty type I without arytenoid adduction in patients with unilateral laryngeal nerve paralysis: the montgomery implant versus the Gore-Tex implant. Acta Otolaryngol 2004;124:732-738. https://doi.org/10.1080/00016480310016875.
Song SA, Santeerapharp A, Choksawad K, Franco RA Jr. Revisions and complications with Gore-Tex medialisation laryngoplasty: a 19-year experience. Clin Otolaryngol 2021;46:864-868. https://doi.org/10.1111/coa.13739.
Schneider AL, Lavin JM. Publicly available databases in otolaryngology quality improvement. Otolaryngol Clin North Am 2019;52:185-194. https://doi.org/10.1016/j.otc.2018.08.004.
Prasad KG, Nelson BG, Deig CR, Schneider AL, Moore MG. ACS NSQIP risk calculator: an accurate predictor of complications in major head and neck surgery? Otolaryngol Neck Surg 2016;155:740-742. https://doi.org/10.1177/0194599816655976.