Abstract：
UNASSIGNED: Temporal bone resection (TBR) with or without neck dissection (ND) is performed for otologic malignancies with occult or clinical cervical lymph node metastases. To date, characterization of post-operative complications in single institution case series may be non-representative of real-world outcomes. Here, we used data from the National Inpatient Sample (NIS) to comprehensively assess the complications encountered, their frequencies, and to identify underlying risk factors to improve future outcomes.
METHODS: The population was patients undergoing TBR and ND derived from the NIS between the years of 2017 and 2019. We utilized ICD-10 diagnosis codes to identify patients with post-operative complications, those discharged to non-home facilities (DNHF), and those with increased length of stay (LOS). Multivariable regression was performed to identify significant variables related to the above outcomes.
UNASSIGNED: Ninety of 277 patients that underwent LTBR with ND had postoperative complications. Wound complications were the most frequent complication, occurring in 11 (4%) of patients, followed by CSF leak (n = 6; 2.2%), with acute respiratory failure being the most common medical complication (n = 4; 1.4%). Sixteen percent (45/277) were discharged to a facility besides home. Dementia (OR = 7.96; CI95 3.62-17.48), anemia (OR = 2.39; CI95 1.15-4.99), congestive heart failure (OR = 5.31; CI95 1.82-15.45), COPD (OR = 3.70; CI95 1.35-10.16), and history of prior stroke (OR = 8.50; CI95 1.55-46.68) increased the odds of DNHF. When evaluating LOS (median = 5 days, IQR = 1, 9), anemia (OR = 5.49; CI95 2.86-10.52), and Medicaid insurance (OR = 3.07; CI95 1.06-10.52) were found to increase the LOS.
UNASSIGNED: The vast majority of patients undergoing LTBR with ND have no complications and are discharged within a week. Liver disease is a risk factor for medical complications and increased charges. Patients with dementia or a prior stroke are at risk for DNHF, and those with prior anemia are at risk for a wound complication.
UNASSIGNED: This study identified factors related to worse post-operative outcomes in patients undergoing temporal bone resection and neck dissection. Although safe for most patients, an existing diagnosis of liver disease, stroke, dementia, and anemia specifically are at risk for developing negative outcomes.
UNASSIGNED: 3.
METHODS: The population was patients undergoing TBR and ND derived from the NIS between the years of 2017 and 2019. We utilized ICD-10 diagnosis codes to identify patients with post-operative complications, those discharged to non-home facilities (DNHF), and those with increased length of stay (LOS). Multivariable regression was performed to identify significant variables related to the above outcomes.
UNASSIGNED: Ninety of 277 patients that underwent LTBR with ND had postoperative complications. Wound complications were the most frequent complication, occurring in 11 (4%) of patients, followed by CSF leak (n = 6; 2.2%), with acute respiratory failure being the most common medical complication (n = 4; 1.4%). Sixteen percent (45/277) were discharged to a facility besides home. Dementia (OR = 7.96; CI95 3.62-17.48), anemia (OR = 2.39; CI95 1.15-4.99), congestive heart failure (OR = 5.31; CI95 1.82-15.45), COPD (OR = 3.70; CI95 1.35-10.16), and history of prior stroke (OR = 8.50; CI95 1.55-46.68) increased the odds of DNHF. When evaluating LOS (median = 5 days, IQR = 1, 9), anemia (OR = 5.49; CI95 2.86-10.52), and Medicaid insurance (OR = 3.07; CI95 1.06-10.52) were found to increase the LOS.
UNASSIGNED: The vast majority of patients undergoing LTBR with ND have no complications and are discharged within a week. Liver disease is a risk factor for medical complications and increased charges. Patients with dementia or a prior stroke are at risk for DNHF, and those with prior anemia are at risk for a wound complication.
UNASSIGNED: This study identified factors related to worse post-operative outcomes in patients undergoing temporal bone resection and neck dissection. Although safe for most patients, an existing diagnosis of liver disease, stroke, dementia, and anemia specifically are at risk for developing negative outcomes.
UNASSIGNED: 3.
摘要：
■对于具有隐匿性或临床颈部淋巴结转移的耳科恶性肿瘤，进行有或没有颈部淋巴结清扫术（ND）的颞骨切除术（TBR）。迄今为止,单个机构病例系列中术后并发症的表征可能无法代表真实世界的结果.这里,我们使用来自国家住院患者样本（NIS）的数据来全面评估遇到的并发症，他们的频率,并确定潜在的风险因素，以改善未来的结果。
方法：人群是在2017年至2019年期间接受来自NIS的TBR和ND的患者。我们利用ICD-10诊断代码来识别术后并发症的患者，那些被排放到非家庭设施(DNHF)的人，以及那些停留时间增加(LOS)的人。进行多变量回归以确定与上述结果相关的重要变量。
■277例接受LTBR的ND患者中有90例出现术后并发症。伤口并发症是最常见的并发症，发生在11例（4%）患者中，其次是脑脊液泄漏(n=6；2.2%)，急性呼吸衰竭是最常见的医疗并发症（n=4；1.4％）。百分之十六（45/277）被送往家庭以外的设施。痴呆（OR=7.96；CI953.62-17.48），贫血（OR=2.39；CI951.15-4.99），充血性心力衰竭（OR=5.31；CI951.82-15.45），COPD（OR=3.70；CI951.35-10.16），和既往卒中病史（OR=8.50；CI951.55-46.68）增加了DNHF的几率。评估LOS时(中位数=5天，IQR=1,9),贫血（OR=5.49；CI952.86-10.52），和医疗补助保险(OR=3.07；CI951.06-10.52)被发现增加了LOS。
■绝大多数接受LTBR伴ND的患者没有并发症，并在一周内出院。肝病是医疗并发症和费用增加的危险因素。患有痴呆或先前中风的患者有发生DNHF的风险，那些有贫血的人有伤口并发症的风险。
■本研究确定了颞骨切除和颈清扫术患者术后预后较差的相关因素。虽然对大多数患者来说是安全的，现有的肝病诊断，中风,痴呆症,特别是贫血有发展为负面结果的风险。
■3.
方法：人群是在2017年至2019年期间接受来自NIS的TBR和ND的患者。我们利用ICD-10诊断代码来识别术后并发症的患者，那些被排放到非家庭设施(DNHF)的人，以及那些停留时间增加(LOS)的人。进行多变量回归以确定与上述结果相关的重要变量。
■277例接受LTBR的ND患者中有90例出现术后并发症。伤口并发症是最常见的并发症，发生在11例（4%）患者中，其次是脑脊液泄漏(n=6；2.2%)，急性呼吸衰竭是最常见的医疗并发症（n=4；1.4％）。百分之十六（45/277）被送往家庭以外的设施。痴呆（OR=7.96；CI953.62-17.48），贫血（OR=2.39；CI951.15-4.99），充血性心力衰竭（OR=5.31；CI951.82-15.45），COPD（OR=3.70；CI951.35-10.16），和既往卒中病史（OR=8.50；CI951.55-46.68）增加了DNHF的几率。评估LOS时(中位数=5天，IQR=1,9),贫血（OR=5.49；CI952.86-10.52），和医疗补助保险(OR=3.07；CI951.06-10.52)被发现增加了LOS。
■绝大多数接受LTBR伴ND的患者没有并发症，并在一周内出院。肝病是医疗并发症和费用增加的危险因素。患有痴呆或先前中风的患者有发生DNHF的风险，那些有贫血的人有伤口并发症的风险。
■本研究确定了颞骨切除和颈清扫术患者术后预后较差的相关因素。虽然对大多数患者来说是安全的，现有的肝病诊断，中风,痴呆症,特别是贫血有发展为负面结果的风险。
■3.
