Open AccessPatient Safety/Quality Improvement
Author(s) -
Daniella Monroy,
Juan Carlos Hernaiz,
Nicolás Pérez,
Akihiro Kishino,
Ken Hayashi,
L. Thompson,
Lori Lemonnier
Publication year - 2017
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599817717250g
Subject(s) - citation , quality (philosophy) , computer science , patient safety , information retrieval , world wide web , health care , political science , philosophy , epistemology , law
Unadjusted univariate analysis was performed to ascertain differences in patient characteristics and surgical approaches between NS and OHNS. Significantly different demographic, clinical, and surgical factors were corrected for using a logistic regression model to assess outcomes. Results: A total of 799 patients who had undergone surgical treatment for vestibular schwannoma were included: NS and OHNS acted as the primary method in 633 and 163 cases, respectively. On univariate analysis, there was no significant difference in operating time (403 vs 396 minutes, P = .59) or length of hospital stay (4.9 vs 4.7 days, P = .49) for NS versus OHNS, respectively. Surgical approach varied by specialty: middle cranial fossa was used in 2.8 versus 4.3%, retrosigmoid in 73.4 versus 31.2%, and transtemporal in 23.6 versus 64.4% of cases performed by NS versus OHNS, respectively (P < .001). Using logistic regression modeling, OHNS was found to have higher rates of reoperation (3.3% vs 1%, odds ratio 5.23, P = .035). Conclusions: Otolaryngologists and neurosurgeons appear to achieve equivalent outcomes on measured metrics of operating time, length of hospital stay, and perioperative complications. However, higher rates of reoperation were observed in OHNS patients and persisted after controlling for differences in patient comorbidities and surgical approach.