Author(s)
Brandon Boyarsky, BS
Abdulla Ahmed, BS
Tatiana Ferraro, BS
Arthur Drouaud, BS
Arjun Joshi, MD
Affiliation(s)
Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine & Health Sciences;
Abstract:
Objective:
To investigate comorbidities, behavioral characteristics, and demographical characteristics as predictors of 30-day postoperative outcomes in submandibular or sublingual gland excisions.
Study Design:
A retrospective cohort analysis of 2456 patients who underwent submandibular or sublingual gland excision between 2011-2021.
Methods:
Patients were identified in the National Surgery Quality Improvement Program database using the following CPT codes: 42408, 42409, 42440, 42450. Primary outcomes were surgical complications (surgical site infections, wound dehiscence, and blood transfusions perioperatively), medical complications (several different systemic complications post-surgery), reoperation, and operation time. Several predictors were identified, and univariate and multivariate logistic regression analyses were performed to investigate the associations between these predictors and 30-day postoperative outcomes. Statistical significance was declared at p <0.05.
Results:
Common comorbidities were diabetes mellitus (non-insulin: 211, insulin: 99), COPD, hypertension (n=955), smoking (n=500), and steroid use (n=68). Surgical complications occurred in 4.45% (n=109) and medical complications in 1.43% (n =35) of patients. Binary logistic regression revealed medical complications were associated with inpatient status (OR=10.230, P<.001) and smoking (OR=2.613, P=.033). Reoperations were more frequent among inpatients (OR=3.833, P<.001) and smokers (OR=2.711, P=.007). Surgical complications were correlated with diabetic patients without insulin (OR=1.945, P=.033) and inpatients (OR=4.167, P<.001). Longer operation times were seen with disseminated cancer (95% CI [17.308-90/365], P<.001), smokers (95% CI [2.1-16.47], P=0.011), and inpatients (95% CI [83.075-100.508], P<.001), but were shorter among general surgeons (95% CI [-29.543- -2.597], P=.019).
Conclusions:
To our knowledge, this was the first multi-institutional retrospective study investigating predictors of 30-day postoperative outcomes of submandibular and sublingual gland excisions. Multivariate analysis indicated that inpatients and smokers were more likely to have medical complications and reoperation. Surgical complications were correlated with DM patients without insulin and inpatients. Patients with disseminated cancer, smokers, and inpatients were associated with longer operative times.