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Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures
Author(s) -
Lebo Nicole L.,
Quimby Alexandra E.,
Caulley Lisa,
Thavorn Kednapa,
Kekre Natasha,
Brode Sarah,
JohnsonObaseki Stephanie
Publication year - 2020
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.28512
Subject(s) - medicine , surgical site infection , confidence interval , incidence (geometry) , head and neck , hazard ratio , retrospective cohort study , surgery , cohort , cohort study , emergency medicine , physics , optics
Objectives/Hypothesis Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS). Study Design Retrospective cohort analysis. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement Program was undertaken. All adult patients undergoing complex HNS from 2005 to 2016 were included in the analysis. Our main outcomes were SSI incidence and increase in hospital LOS attributable to SSI. Results Of 4,014 patients identified, 16.5% developed SSI. History of smoking, diabetes, preoperative wound infection, contaminated or dirty wound classes, and prolonged operative time were found to significantly predict postoperative SSI. Adjusting for significant pre‐ and postoperative factors, SSI was associated with significantly increased LOS (hazard ratio = 0.486, 95% confidence interval: 0.419‐0.522). Conclusions SSI following complex HNS is associated with significantly increased hospital LOS. This result supports the need for institutional QI strategies that target SSIs after head and neck procedures in an effort to provide the highest quality care at the lowest possible cost. Our analysis identifies risk factors that can allow identification of patients at high risk of SSI and prolonged hospitalization. Level of Evidence 2b Laryngoscope , 2020