Author(s)
Pablo Llerena, BA
Samer T. Elsamna, BA
Vraj P. Shah, BS
Prayag S. Patel, MD
Christina H. Fang, MD
Soly Baredes, MD
Jean Anderson Eloy, MD
Affiliation(s)
Rutgers New Jersey Medical School;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to identify risk factors associated with intubation and ventilation following laryngectomy procedure.
Objectives: Laryngectomy is a complex procedure, with several potential postoperative complications. Intubation and ventilation (I/V) are among these and associated with further morbidity and mortality. We sought to investigate risk factors associated with I/V following laryngectomy.
Study Design: Retrospective study of a national outcomes based surgical database.
Methods: Cases of total and subtotal laryngectomy from 2005-2018 were obtained from the National Surgical Quality Improvement Program using CPT codes. Demographics and comorbidities were assessed between I/V and no I/V cohorts using chi square and logistic regression to determine odds ratios (OR).
Results: 2889 cases of laryngectomy were identified. 4.6% of cases had postoperative I/V (n = 133). Variables predictive of undergoing I/V after laryngectomy were age as a continuous variable (OR:1.05, 95% CI: 1.01-1.08, p = 0.005) and patients who had prior chemotherapy (OR: 5.66, 95% CI: 1.94-16.6, p = 0.002) on multivariate analysis. Laryngectomy type, American Society of Anesthesiologists physical classification, smoking, and other common comorbidities were not associated with an increased risk for I/V following laryngectomy.
Conclusions: Intubation and ventilation can occur in the postoperative setting following laryngectomy (4.6%). Increased age and history of chemotherapy were both associated with I/V. Smoking and extent of laryngectomy were not associated with I/V.