Risk factors and outcomes after surgery for malignant neoplasm of the parotid gland: An ACS-NSQIP study.
ACS-NSQIP
Big data database
Parotid gland malignancy
Parotid gland surgery
Risk factors
Journal
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239
Informations de publication
Date de publication:
25 Sep 2024
25 Sep 2024
Historique:
received:
26
05
2024
revised:
12
08
2024
accepted:
10
09
2024
medline:
25
10
2024
pubmed:
25
10
2024
entrez:
24
10
2024
Statut:
aheadofprint
Résumé
Malignant neoplasms of the parotid gland (MPG) are clinically challenging due to aggressive growth and metastasis. Despite tumor resection being the primary treatment, there is a paucity of studies on postsurgical outcomes and preoperative risk factors for MPG. We queried the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent MPG surgery between 2008 and 2021. 30-day postoperative outcomes and risk factors predisposing to the occurrence of complications were assessed. The study population included 3052 patients, the majority of whom were males (n = 1842; 60%) and White (n = 2017; 66%). The average age was 63 ± 16 years. The most common comorbidities were obesity (n = 1182; 39%) and hypertension (n = 1533; 50%). Surgical procedures were performed predominantly in the inpatient setting (n = 1773; 58%) by ENT surgeons (n = 2767; 91%). Overall, complications were reported in 6.8% (n = 209) of patients. Inpatient setting (p < 0.001), renal failure (p < 0.001), smoking (p = 0.012), as well as increased creatinine (p < 0.001) and blood urea nitrogen (BUN) levels (p = 0.001) were identified as risk factors for complications. In addition, concurrent microsurgical procedures such as flap surgery and/or nerve grafting significantly increased the risk of postoperative adverse events (p < 0.001). Our analysis revealed that complication rates were associated with high creatinine and BUN levels, inpatient surgery, renal failure, higher American Society of Anesthesiology classes, and smoking. We also found that concurrent microsurgical procedures were predictive factors for complications. These findings can inform patient counseling, preoperative planning, and risk stratification.
Sections du résumé
BACKGROUND
BACKGROUND
Malignant neoplasms of the parotid gland (MPG) are clinically challenging due to aggressive growth and metastasis. Despite tumor resection being the primary treatment, there is a paucity of studies on postsurgical outcomes and preoperative risk factors for MPG.
MATERIALS AND METHODS
METHODS
We queried the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent MPG surgery between 2008 and 2021. 30-day postoperative outcomes and risk factors predisposing to the occurrence of complications were assessed.
RESULTS
RESULTS
The study population included 3052 patients, the majority of whom were males (n = 1842; 60%) and White (n = 2017; 66%). The average age was 63 ± 16 years. The most common comorbidities were obesity (n = 1182; 39%) and hypertension (n = 1533; 50%). Surgical procedures were performed predominantly in the inpatient setting (n = 1773; 58%) by ENT surgeons (n = 2767; 91%). Overall, complications were reported in 6.8% (n = 209) of patients. Inpatient setting (p < 0.001), renal failure (p < 0.001), smoking (p = 0.012), as well as increased creatinine (p < 0.001) and blood urea nitrogen (BUN) levels (p = 0.001) were identified as risk factors for complications. In addition, concurrent microsurgical procedures such as flap surgery and/or nerve grafting significantly increased the risk of postoperative adverse events (p < 0.001).
CONCLUSIONS
CONCLUSIONS
Our analysis revealed that complication rates were associated with high creatinine and BUN levels, inpatient surgery, renal failure, higher American Society of Anesthesiology classes, and smoking. We also found that concurrent microsurgical procedures were predictive factors for complications. These findings can inform patient counseling, preoperative planning, and risk stratification.
Identifiants
pubmed: 39448324
pii: S1748-6815(24)00621-1
doi: 10.1016/j.bjps.2024.09.067
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declarations of interest None.