TY - JOUR
T1 - National Trends in Vestibular Schwannoma Surgery
T2 - Influence of Patient Characteristics on Outcomes
AU - Hatch, Jonathan L.
AU - Bauschard, Michael J.
AU - Nguyen, Shaun A.
AU - Lambert, Paul R.
AU - Meyer, Ted A.
AU - McRackan, Theodore R.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Objective: To characterize current vestibular schwannoma (VS) surgery outcomes with a nationwide database and identify factors associated with increased complications and prolonged hospital course. Study Design: Retrospective review utilizing the University HealthSystem Consortium national inpatient database. Setting: US academic health centers. Subjects and Methods: Data from patients undergoing VS surgery were analyzed over a 3-year time span (October 2012 to September 2015). Surgical outcomes, such as length of stay (LOS), complications, and mortality, were analyzed on the basis of race, sex, age, and comorbidities during the 30-day postoperative period. Results: A total of 3697 VS surgical cases were identified. The overall mortality rate was 0.38%, and the overall complication rate was 5.3%. Advanced age significantly affected intensive care unit LOS, mortality, and complications (P =.04). Comorbidities, including hypertension, obesity, and depression, also significantly increased complication rates (P =.02). Sixty-eight patients (1.8%) had a history of irradiation, and they had a significantly increased LOS (P =.03). Conclusion: Modern VS surgery has a low mortality rate and a relatively low rate of complications. Several factors contribute to high complication rates, including age and comorbidities. These data will help providers in counseling patients on which treatment course might be best suited for them.
AB - Objective: To characterize current vestibular schwannoma (VS) surgery outcomes with a nationwide database and identify factors associated with increased complications and prolonged hospital course. Study Design: Retrospective review utilizing the University HealthSystem Consortium national inpatient database. Setting: US academic health centers. Subjects and Methods: Data from patients undergoing VS surgery were analyzed over a 3-year time span (October 2012 to September 2015). Surgical outcomes, such as length of stay (LOS), complications, and mortality, were analyzed on the basis of race, sex, age, and comorbidities during the 30-day postoperative period. Results: A total of 3697 VS surgical cases were identified. The overall mortality rate was 0.38%, and the overall complication rate was 5.3%. Advanced age significantly affected intensive care unit LOS, mortality, and complications (P =.04). Comorbidities, including hypertension, obesity, and depression, also significantly increased complication rates (P =.02). Sixty-eight patients (1.8%) had a history of irradiation, and they had a significantly increased LOS (P =.03). Conclusion: Modern VS surgery has a low mortality rate and a relatively low rate of complications. Several factors contribute to high complication rates, including age and comorbidities. These data will help providers in counseling patients on which treatment course might be best suited for them.
KW - facial nerve
KW - postoperative complications
KW - quality improvement
KW - vestibular schwannoma
UR - http://www.scopus.com/inward/record.url?scp=85045302792&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85045302792&partnerID=8YFLogxK
U2 - 10.1177/0194599818765717
DO - 10.1177/0194599818765717
M3 - Article
C2 - 29584554
AN - SCOPUS:85045302792
VL - 159
SP - 102
EP - 109
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
SN - 0194-5998
IS - 1
ER -