Safety of Adult Ambulatory Direct Laryngoscopy

Orosco, Ryan K.; Lin, Harrison W.; Bhattacharyya, Neil

doi:10.1001/jamaoto.2015.1172

Cited by 27 publications

(32 citation statements)

References 22 publications

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“…In this large, multistate cross‐sectional analysis, there was a revisit rate of 5.2% after ambulatory otologic surgery within the first 30 days. This closely compares to the 5.0% revisit rate after sinonasal surgery, similarly compares to revisit rate of 7.2% after ambulatory thyroidectomy, and is lower than the revisit rates after tonsillectomy (11.6%) and ambulatory uvulopalatopharyngoplasty surgery (9.7%), as reported in prior studies . Overall, our data indicate that ambulatory otologic surgeries are relatively safe procedures with a favorable safety profile.…”

Section: Discussionsupporting

confidence: 84%

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Adult ambulatory otologic surgery: Unplanned revisits and complications

2019

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Objectives Determine rates and reasons for unplanned revisits after ambulatory otologic surgery. Methods Cross‐sectional analysis of State Ambulatory Surgery Databases of California, Florida, Iowa, and New York was performed for years 2010 and 2011. Ambulatory adult otology surgical procedures were linked to ambulatory, emergency, and inpatient databases for revisit encounters occurring within 30 days. The numbers of revisits and associated diagnoses were analyzed. Results A total of 16,709 ambulatory otologic cases were extracted (mean age, 50.3 years; 54.2% female). The most common primary procedures performed were tympanoplasty (n = 7,919), stapedectomy (n = 2504), cochlear implantation (n = 1444), tympanomastoidectomy (n = 713), and mastoidectomy (n = 697). The 30‐day revisit rate was 5.2% (n = 875; 95% confidence interval [CI] 4.9%–5.6%). Urinary retention/urinary tract infection (UTI) (n = 93, 10.6%; CI 8.8%–12.9%) was the most common diagnosis at revisit, followed by otalgia (n = 85, 9.7% of revisits; CI: 7.9%–11.9%) and dizziness (n = 80, 9.1%; CI 7.4%–11.2%). Revisits most frequently occurred within the first 10 days postoperatively (47.2% of revisits), and a second revisit occurred 134 times (0.8% of cases). Fewer than 10 cases of facial nerve palsy were diagnosed (CI 0.03%–0.11%). Conclusion With a relatively low unplanned revisit rate, ambulatory otologic surgery demonstrates a favorable safety profile. Common reasons for revisit included pain, urinary retention, and dizziness. Quality improvement measures should be directed at addressing these postoperative issues to minimize rates of complications and unplanned revisits. Level of Evidence NA Laryngoscope, 130:1788–1791, 2020

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Section: Discussionsupporting

confidence: 84%

“…A shift toward outpatient or day‐surgery cases has occurred over the last few decades in many areas within otolaryngology, including otologic surgery . Previously, we have described favorable complication and revisit rates for several nonotologic procedures .…”

Section: Introductionmentioning

confidence: 99%

Adult ambulatory otologic surgery: Unplanned revisits and complications

2019

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“…21 There have been several publications in the surgical literature exploring factors associated with increased readmission rates, and the consensus among this data is that surgical complications have the greatest association with 30-day readmissions, but socioeconomic factors and patient comorbidities also have a significant impact. 15,[22][23][24][25][26][27][28][29] Although we did not find an association between readmission and socioeconomic factors, the presence of an outpatient tracheostomy-related complication carried the greatest odds of readmission on multivariable analysis.…”

Section: -Day Hospital Readmissionsmentioning

confidence: 89%

Complications and 30‐day hospital readmission rates of patients undergoing tracheostomy: A prospective analysis

et al. 2017

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“…Of these procedures, the majority (57.2%) were performed in hospital‐based ambulatory surgery centers . Otolaryngology has increased the amount of outpatient procedures performed annually over the past 20 years, and data supports outpatient management of a wide range of otolaryngologic issues including pediatric disease, airway pathology, and sleep disorders . Further review of the NHSR data revealed that sinonasal procedures accounted for 600,000 ambulatory surgical visits in 2006.…”

Section: Discussionmentioning

confidence: 99%