Age, ASA-status, and Changes in NSQIP Comorbidity Indices Reporting in Facial Fracture Repair.
ASA status
aging population
comorbidity index
facial fracture
post op complications
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
revised:
22
11
2022
received:
15
08
2022
accepted:
16
12
2022
medline:
20
9
2023
pubmed:
11
1
2023
entrez:
10
1
2023
Statut:
ppublish
Résumé
To evaluate the impact of age and the American Society of Anesthesiologists (ASA) classification on post operative outcomes as well as the changes in the National Surgical Quality Improvement Program (NSQIP) database reporting of comorbidity index variables in patients with facial fractures. The NSQIP database was queried for facial fracture repair CPT codes between 2012 and 2019 and for modified Frailty Index (mFI) and modified Charlson Comorbidity Index (mCCI) variables between years 2006 and 2018. The predominant question analyzed two preoperative risk factors: patient and ASA classification. Chi-square analysis, Kruskal-Wallis, Mann-Whitney, Spearman correlation, and multivariable logistic regression were used to evaluate age and ASA classification with wound dehiscence, superficial surgical site infection (SSSI), deep wound infection (DWI), readmission status, and return to the OR. The reporting of indices variables was evaluated with descriptive statistics. In this large database with univariate analysis, patients with a higher ASA classification and older patients experience significantly increased risks of readmission, return to the OR, and longer hospital stays. On multivariate analyses, ASA classes II, III, and IV are independently associated with increased risk of readmission and return to the OR, while controlling for patient age. The reporting of all mFI and mCCI variables were consistent from 2006 to 2010, but after 2011, there has been inconsistent or absent reporting of variables, therefore, conclusions on the impact of comorbidities on facial fracture repair are unreliable. 4 Laryngoscope, 133:2572-2577, 2023.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2572-2577Informations de copyright
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
Références
Allareddy V, Allareddy V, Nalliah RP. Epidemiology of facial fracture injuries. J Oral Maxillofac Surg. 2011;69:2613-2618.
Sethi RKV, Kozin ED, Fagenholz PJ, Lee DJ, Shrime MG, Gray ST. Epidemiological survey of head and neck injuries and trauma in the United States. Otolaryngol-Head Neck Surg. 2014;151:776-784.
Rampa S, Wilson FA, Tak HJ, et al. Patient characteristics and causes of facial fractures in the state of California. J Oral Maxillofac Surg. 2019;77:1855-1866.
Atisha DM, van Renesselaer BT, Allori AC, Puscas L, Erdmann D, Marcus JR. Facial fractures in the aging population. Plast Reconstr Surg. 2016;137:587-593.
Kim K, Ibrahim AMS, Koolen PGL, Lee BT, Lin SJ. Trends in facial fracture treatment using the American College of Surgeons National Surgical Quality Improvement Program database. Plast Reconstr Surg. 2014;133:627-638.
Raikundalia M, Svider PF, Hanba C, et al. Facial fracture repair and diabetes mellitus: an examination of postoperative complications. Laryngoscope. 2017;127:809-814.
Schultz BN, Ottesen T, Ondeck NT, et al. Systemic changes in the National Surgical Quality Improvement Program Database over the year can affect comorbidity indices such as the modified frailty index and modified Charlson comorbidity index for lumbar fusion studies. Spine. 2018;43:798-804.
George EL, Hall DE, Youk A, et al. Association between patient frailty and postoperative mortality across multiple noncardiac surgical specialties. JAMA Surg. 2022;156(1):1-9.
ACS National Surgical Quality Improvement Program. American College of Surgeons. http://www.facs.org/quality-programs/acs-nsqip.
ASA Physical Status Classification System. https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system.
Wolters U, Wolf T, Stützer H, Schröder T. ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth. 1996;77:217-222.
Phan K, Kim JS, Lee NJ, Kothari P, Cho SK. Relationship between ASA scores and 30-day readmissions in patients undergoing anterior cervical discectomy and fusion. Spine. 2017;42:85-91.
Sathiyakumar V, Molina CS, Thakore RV, Obremskey WT, Sethi MK. ASA score as a predictor of 30-day perioperative readmission in patients with orthopaedic trauma injuries: an NSQIP analysis. J Orthop Trauma. 2015;29:e127-e132.
Zeidan M, Goz V, Lakomkin N, Spina N, Brodke DS, Spiker WR. Predictors of readmission and prolonged length of stay after cervical disc arthroplasty. Spine. 2021;46:487-491.
Cohen SM, Rosett BE, Shifrin DA. An analysis of independent variables affecting surgical outcomes in patients undergoing repair of maxillofacial trauma: an American College of Surgeons National Surgical Quality Improvement Program Study. J Craniofac Surg. 2017;28:596-599.
Thepmankorn P, Choi CB, Haimowitz SZ, et al. ASA physical status classification and complications following facial fracture repair. Ann Otol Rhinol Laryngol. 2021;131:I-9.
Daar DA, Kantar RS, Cammarata MJ, et al. Predictors of adverse outcomes in the Management of Mandibular Fractures. J Craniofac Surg. 2019;30:571-577.
Bur AM, Villwock MR, Nallani R, et al. National Database Research in head and neck reconstructive surgery: a call for increased transparency and reproducibility. Otolaryngol Head Neck Surg. 2021;164(2):315-321.