Understanding nationwide readmissions after parotidectomy

Mukdad, Laith; Goel, Alexander N.; Nasser, Hassan; John, Maie A. St.

doi:10.1002/lary.28187

Cited by 7 publications

(7 citation statements)

References 22 publications

(26 reference statements)

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“…Additionally, the readmission rate was 1.47% in the outpatient group and 2.01% in the inpatient group (P = .71), both lower than the national reported rate of 3.9%. 26 Coniglio et al 18 have previously reported that intraoperative drain usage in the parotidectomy procedure does not have a significant impact on postoperative complications. This is concordant with our research, where we found no significant difference in complication rate by drain status.…”

Section: Discussionmentioning

confidence: 98%

Outpatient Parotidectomy, a Safety and Financial Review

Scher

Cabrera

Cai

et al. 2021

Ann Otol Rhinol Laryngol

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Objective: The objective of this study is to investigate the safety, efficacy, and potential cost-savings of the outpatient parotidectomy procedure. Methods: This is a retrospective chart review of all patients who underwent a parotidectomy at a large academic center from 2015 through 2019 including demographic data, postoperative complications, drain placement, readmission, and financial cost. A comparison was performed between patients who underwent an outpatient vs inpatient parotidectomy. Results: A total of 335 patients underwent parotidectomy (136 outpatient; 199 inpatient). Comparison of patient demographics, common comorbidities, tumor size, tumor type, postoperative complications, and readmission rate was similar between the inpatient and outpatient cohorts. The overall mean cost difference between inpatient parotidectomy and outpatient parotidectomy for all years was $1528.58 (95%CI: $1139-$1916). Conclusion: The outpatient parotidectomy procedure has a comparable safety profile to the inpatient procedure while providing a significant cost-savings benefit.

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Section: Discussionmentioning

confidence: 98%

Outpatient Parotidectomy, a Safety and Financial Review

Scher

Cabrera

Cai

et al. 2021

Ann Otol Rhinol Laryngol

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“…Interestingly, the readmission rates gathered from National Surgical Quality Improvement Program appear to be lower than the 4 per cent readmission rate calculated from the nationwide readmission database. 32 This discordance of values may be attributed to the fact that the National Surgical Quality Improvement Program only considers readmissions within 30 days post-operatively whereas the nationwide readmission database accounts for 30 days after discharge. Thus, if a patient had a prolonged hospital stay, American College of Surgeons National Surgical Quality Improvement Program may have underestimated the readmission rate.…”

Section: Discussionmentioning

confidence: 99%

Evaluating resident involvement and the ‘July effect’ in parotidectomy

et al. 2021

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Objective This study aimed to evaluate the effect of resident involvement and the ‘July effect’ on peri-operative complications after parotidectomy. Method The American College of Surgeons National Surgical Quality Improvement Program database was queried for parotidectomy procedures with resident involvement between 2005 and 2014. Results There were 11 733 cases were identified, of which 932 involved resident participation (7.9 per cent). Resident involvement resulted in a significantly lower reoperation rate (adjusted odds ratio, 0.18; 95 per cent confidence interval, 0.05–0.73; p = 0.02) and readmission rate (adjusted odds ratios 0.30; 95 per cent confidence interval, 0.11–0.80; p = 0.02). However, resident involvement was associated with a mean 24 minutes longer adjusted operative time and 23.5 per cent longer adjusted total hospital length of stay (respective p < 0.01). No significant difference in surgical or medical complication rates or mortality was found when comparing cases among academic quarters. Conclusion Resident participation is associated with significantly decreased reoperation and readmission rates as well as longer mean operative times and total length of stay. Resident transitions during July are not associated with increased risk of adverse peri-operative outcomes after parotidectomy.

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“…Another recent US nationwide study has found that a LOS [? ]2 days was an independent risk factor for readmission within 30 days following parotidectomy [ 25 ]. Considering that the cost of a hospitalization day is USD [?…”

Section: Discussionmentioning

confidence: 99%

Drainless Parotidectomy Using Tissue Fibrin Sealant -- A Case-Control Study

Cohen¹,

Chaushu²,

K³

et al. 2021

Preprint

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Objectives: Drainless parotidectomy has been reported infrequently, mostly in patients undergoing limited partial parotidectomies. Evicel is a fibrin sealant (FS) glue whose use has not been reported in head and neck surgeries so far. The aim of the study was to investigate the impact of drainless parotidectomy using FS on the surgical outcome. Design: A retrospective matched case-control series. Settings: A single academic center, Participants: All cases of patients who underwent drainless parotidectomies, including deep lobe tumors and revision surgeries, were compared to age, sex, body mass index and tumor-matched controls in which a suction drain was inserted. Main outcome measures: length of hospital stay (LOS). Secondary outcomes included post-operative seroma and related complications. Results: A total of 123 patients (41 cases and 82 controls) were included in the study. Pre-operative and intra-operative characteristic did not differ significantly between the FS group and controls. A borderline significance was found for surgery type as the FS group had higher rates of total parotidectomy compared with the control group (25.0% vs. 10.5%, p=0.054). LOS was significantly shorter in the FS group (1.0±0.3 vs. 1.5±0.6 days, p<0.001). The rates of post-operative seroma, aspirations, local infection and post-operative antibiotic treatment were all lower in the FS group compared with the control group, but did not reach statistical significance. Conclusion: A drainless parotidectomy using the EVICEL FS is safe, reduces LOS, and may reduce post-operative seroma and its associated complications. This procedure may be applied to deep parotid tumors, parapharyngeal involvement and revision surgery.

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Understanding nationwide readmissions after parotidectomy

Cited by 7 publications

References 22 publications

Outpatient Parotidectomy, a Safety and Financial Review

Outpatient Parotidectomy, a Safety and Financial Review

Evaluating resident involvement and the ‘July effect’ in parotidectomy

Drainless Parotidectomy Using Tissue Fibrin Sealant -- A Case-Control Study

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