Alcohol Withdrawal Prophylaxis in Patients Undergoing Surgical Treatment of Head and Neck Squamous Cell Carcinoma

Neyman, K; Gourin, Christine G.; Terris, David J.

doi:10.1097/01.mlg.0000160085.98289.e8

Cited by 21 publications

(21 citation statements)

References 10 publications

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“…We added a variable for altered mental status, which included alcohol withdrawal, given its association with postoperative complications. 15,16 We also added donor site function to assess short-term disability from free tissue transfer.…”

Section: Resultsmentioning

confidence: 99%

Development and Feasibility of a Specialty-Specific National Surgical Quality Improvement Program (NSQIP)

Lewis

Aloia

Shi

et al. 2016

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) serves the need for continual quality assessment in general surgery. Previously, no parallel mechanism specific to head and neck oncologic surgery existed. OBJECTIVE To address the need for continual quality assessment in subspecialty surgery by adapting the ACS NSQIP platform for complex head and neck oncologic surgical procedures. DESIGN, SETTING, AND PARTICIPANTS With an institutional ACS NSQIP team’s guidance, surgeons from the departments of head and neck surgery and plastic and reconstructive surgery developed disease- and procedure-specific preoperative, intraoperative, and postoperative variables specific to head and neck surgery requiring reconstruction. Collection occurred with 100% sampling and standard ACS NSQIP 30-day follow-up. After a pilot period, long-term functional outcomes were added to this platform. A total of 312 patients underwent head and neck surgery requiring reconstruction at an academic medical center between August 1, 2012, and June 30, 2013. EXPOSURES Development of a specialty-specific head and neck surgery ACS NSQIP platform. MAIN OUTCOMES AND MEASURES The feasibility of adapting the ACS NSQIP platform to capture complex head and neck surgery metrics in all patients. RESULTS Head and neck surgery–specific preoperative, intraoperative, and postoperative variables were added to the ACS NSQIP platform and evaluated in 312 patients (201 [64.4%] male). Only 42 patients (13.5%) had no preoperative risk factors, and 136 (43.6%) had 3 or more risk factors. The mean (SD) duration of operation was 9.4 (3.0) hours (range, 1.7–19.3 hours). The mean (SD) postoperative length of stay was 7.9 (4.7) days (range, 1–40 days), 58 patients (18.6%) had an unplanned return to the operating room, 23 patients (7.4%) were readmitted within 30 days, and 3 patients (1.0%) died within 30 days. More than half of the patients (160 [51.3%]) did not experience a postoperative occurrence. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first comprehensive complex oncologic surgery outcomes platform derived from ACS NSQIP methods. The initial pilot demonstrates the ability to systematically capture head and neck surgery–specific variables with complete sampling. With multi-institutional expansion, increased accrual, and long-term patient-reported outcomes, we hope to set risk-adjusted benchmarks that may underpin quality improvement efforts in complex head and neck surgery.

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Section: Resultsmentioning

confidence: 99%

Development and Feasibility of a Specialty-Specific National Surgical Quality Improvement Program (NSQIP)

Lewis

Aloia

Shi

et al. 2016

JAMA Otolaryngol Head Neck Surg

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“…In surgical patients, alcohol abuse has been shown to be a significant risk factor for increased postoperative morbidity and mortality 1, 6, 7. Patients who abuse alcohol have significantly more postoperative complications and longer in‐hospital lengths of stay compared to patients without a history of alcohol abuse,1, 8–12 due at least in part to increased rates of infection, bleeding, and cardiopulmonary dysfunction 1, 8, 11, 12…”

Section: Introductionmentioning

confidence: 99%

The effect of alcohol abuse and alcohol withdrawal on short‐term outcomes and cost of care after head and neck cancer surgery

Genther

Gourin

2012

The Laryngoscope

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“…The average increase in overall hospital stay was statistically significant for those patients experiencing withdrawal symptoms and DTs. The AWD group had a length of stay 6.1 days longer and the group experiencing DTs 9.6 days longer (Neyman et al, 2005). A delay in identification and treatment could be life threatening for the patient experiencing AWD.…”

Section: Background/literaturementioning

confidence: 97%

Nursing implications of alcohol withdrawal in the postoperative orthopaedic patient

Cunningham

Puskar

2007

Journal of Orthopaedic Nursing

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Alcohol Withdrawal Prophylaxis in Patients Undergoing Surgical Treatment of Head and Neck Squamous Cell Carcinoma

Cited by 21 publications

References 10 publications

Development and Feasibility of a Specialty-Specific National Surgical Quality Improvement Program (NSQIP)

Development and Feasibility of a Specialty-Specific National Surgical Quality Improvement Program (NSQIP)

The effect of alcohol abuse and alcohol withdrawal on short‐term outcomes and cost of care after head and neck cancer surgery

Nursing implications of alcohol withdrawal in the postoperative orthopaedic patient

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