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Postoperative complications of total laryngectomy in diabetic patients
Author(s) -
Filimonov Andrey,
Brady Jacob S.,
Govindan Aparna,
Merchant Aziz,
Eloy Jean Anderson,
Baredes Soly,
Park Richard Chan Woo
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26478
Subject(s) - medicine , propensity score matching , diabetes mellitus , cohort , retrospective cohort study , laryngectomy , surgery , odds ratio , larynx , endocrinology
Objectives/Hypothesis Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL. Study Design Retrospective analysis of surgical outcomes database Methods The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software. Equal distribution of demographics and preoperative comorbidities was ensured between the diabetic and nondiabetic cohorts using a propensity‐matching algorithm. Results Following propensity matching there were 495 TL patients included in this study. Among these, 110 (22.2%) were diabetic and 385 (77.8%) were nondiabetic. The only comorbidities associated with the diabetic cohort after matching were obesity, previous percutaneous coronary intervention, and hypertension. The rates of superficial surgical site infections were higher in the diabetic patient cohort (10.9% vs. 4.7%, P = .022). There were no significant differences in unplanned readmission (12.7% vs. 9.1%, P = .260), reoperation (14.3% vs. 15.1%, P = .864), and mortality (1.8% vs. 2.6%, P = 1.000) between the diabetic and the nondiabetic groups. Multivariate regression utilizing preoperative variables not accounted for by propensity matching showed that superficial surgical site infections were still higher in the diabetes cohort (odds ratio: 3.371, P = .021). Conclusions Diabetic patients undergoing TL showed an increased incidence of superficial surgical site infections postoperatively. There were no other significant differences in readmission, reoperation, and mortality. Level of Evidence 4 Laryngoscope , 127:2247–2251, 2017