TY - JOUR
T1 - Age, ASA-status, and Changes in NSQIP Comorbidity Indices Reporting in Facial Fracture Repair
AU - Khandalavala, Karl R.
AU - Boochoon, Kieran
AU - Schissel, Makayla
AU - Heckman, W. Wesley
AU - Geelan-Hansen, Katie
N1 - Publisher Copyright:
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2023/10
Y1 - 2023/10
N2 - Objective: To evaluate the impact of age and the American Society of Anesthesiologists (ASA) classification on post operative outcomes as well as the changes in the National Surgical Quality Improvement Program (NSQIP) database reporting of comorbidity index variables in patients with facial fractures. Methods: The NSQIP database was queried for facial fracture repair CPT codes between 2012 and 2019 and for modified Frailty Index (mFI) and modified Charlson Comorbidity Index (mCCI) variables between years 2006 and 2018. The predominant question analyzed two preoperative risk factors: patient and ASA classification. Chi-square analysis, Kruskal-Wallis, Mann–Whitney, Spearman correlation, and multivariable logistic regression were used to evaluate age and ASA classification with wound dehiscence, superficial surgical site infection (SSSI), deep wound infection (DWI), readmission status, and return to the OR. The reporting of indices variables was evaluated with descriptive statistics. Conclusion: In this large database with univariate analysis, patients with a higher ASA classification and older patients experience significantly increased risks of readmission, return to the OR, and longer hospital stays. On multivariate analyses, ASA classes II, III, and IV are independently associated with increased risk of readmission and return to the OR, while controlling for patient age. The reporting of all mFI and mCCI variables were consistent from 2006 to 2010, but after 2011, there has been inconsistent or absent reporting of variables, therefore, conclusions on the impact of comorbidities on facial fracture repair are unreliable. Level of Evidence: 4 Laryngoscope, 133:2572–2577, 2023.
AB - Objective: To evaluate the impact of age and the American Society of Anesthesiologists (ASA) classification on post operative outcomes as well as the changes in the National Surgical Quality Improvement Program (NSQIP) database reporting of comorbidity index variables in patients with facial fractures. Methods: The NSQIP database was queried for facial fracture repair CPT codes between 2012 and 2019 and for modified Frailty Index (mFI) and modified Charlson Comorbidity Index (mCCI) variables between years 2006 and 2018. The predominant question analyzed two preoperative risk factors: patient and ASA classification. Chi-square analysis, Kruskal-Wallis, Mann–Whitney, Spearman correlation, and multivariable logistic regression were used to evaluate age and ASA classification with wound dehiscence, superficial surgical site infection (SSSI), deep wound infection (DWI), readmission status, and return to the OR. The reporting of indices variables was evaluated with descriptive statistics. Conclusion: In this large database with univariate analysis, patients with a higher ASA classification and older patients experience significantly increased risks of readmission, return to the OR, and longer hospital stays. On multivariate analyses, ASA classes II, III, and IV are independently associated with increased risk of readmission and return to the OR, while controlling for patient age. The reporting of all mFI and mCCI variables were consistent from 2006 to 2010, but after 2011, there has been inconsistent or absent reporting of variables, therefore, conclusions on the impact of comorbidities on facial fracture repair are unreliable. Level of Evidence: 4 Laryngoscope, 133:2572–2577, 2023.
KW - ASA status
KW - aging population
KW - comorbidity index
KW - facial fracture
KW - post op complications
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U2 - 10.1002/lary.30559
DO - 10.1002/lary.30559
M3 - Article
C2 - 36625305
AN - SCOPUS:85146181418
SN - 0023-852X
VL - 133
SP - 2572
EP - 2577
JO - Laryngoscope
JF - Laryngoscope
IS - 10
ER -