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Neck hematoma after major head and neck surgery: Risk factors, costs, and resource utilization
Author(s) -
ShahBecker Shivani,
Greenleaf Erin K.,
Boltz Melissa M.,
Hollenbeak Christopher S.,
Goyal Neerav
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25102
Subject(s) - medicine , hematoma , coagulopathy , odds ratio , complication , surgery , postoperative hematoma , logistic regression
Background Postoperative cervical hematoma after major head and neck surgery is a feared complication. However, risk factors for developing this complication and attributable costs are not well‐established. Methods The Nationwide Inpatient Sample database was utilized compare patients with and without postoperative cervical hematoma. Logistic regression was used to analyze risk factors for hematoma formation and 30‐day mortality. Total inpatient length of stay (LOS) and costs were fit to generalized linear models. Results Of 32 071 patients, 1098 (3.4%) experienced a postoperative cervical hematoma. Male sex (odds ratio [OR] 1.38; P < .0001), black race (OR 1.35; P = .010), 4 or more comorbidities (OR 1.66; P < .0001), or presence of a preoperative coagulopathy (OR 6.76; P < .0001) were associated. Postoperative cervical hematoma was associated with 540% increased odds of death ( P < .0001). The LOS and total excess costs were 5.14 days ( P < .0001) and $17 887.40 ( P < .0001), respectively. Conclusion Although uncommon, postoperative cervical hematoma is a life‐threatening complication of head and neck surgery with significant implications for outcomes and resource utilization.