title: Predictors of adverse events after parotidectomy: a review of 2919 cases.
abstract: OBJECTIVE
  There is a current paucity of large-scale, multi-institutional studies that explore the risk factors for major complications following parotidectomy.
  
  
  METHODS
  The American College of Surgeons National Surgical Quality Improvement Program participant use file was reviewed to identify all patients who had undergone parotidectomy between 2006 and 2011. Risk factors that predicted adverse events were estimated by using multivariate logistic regression.
  
  
  RESULTS
  Of 2919 included patients, 202 patients experienced adverse outcomes within the first 30 days of surgery. These included surgical complications in 76 (2.6%) patients; medical complications in 90 (3.1%) patients; death in 7 (0.2%) patients; and reoperation in 77 (2.6%) patients. Predictors of any complication included disseminated cancer (odds ratio [OR] = 2.28; 95% confidence interval [CI], 1.05-4.95; P = .036) and increasing total relative value units (OR = 1.01; 95% CI, 1.00-1.02; P = .027). Active smoking was a major risk factor for surgical complications (OR = 1.81; 95% CI, 1.08-3.05; P = .025). Dyspnea (OR = 2.93; 95% CI, 1.37-6.27; P = .006) significantly predicted medical complications.
  
  
  CONCLUSIONS
  Although complication rates after parotidectomy are generally low, avoidance of specific and nonspecific postoperative complications still remains an area for improvement. Future outcomes databases should include procedure-specific complications, including facial nerve injury.
authors.affiliation: Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, Illinois, USA.
authors.forename: Bobby D
authors.initials: BD
authors.lastname: Kim
authors.affiliation: Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, Illinois, USA.
authors.forename: Seokchun
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Josh
authors.initials: J
authors.lastname: Wood
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Samant
authors.affiliation: Division of Plastic and Reconstructive Surgery, Baptist Cancer Center-Vanderbilt-Ingram Cancer Center, Memphis, Tennessee, USA jpverhalen@gmail.com.
authors.forename: Jon P
authors.initials: JP
authors.lastname: Ver Halen
authors.affiliation: Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: John Y S
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D004417:Dyspnea / Q000150:complications; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010305:Parotid Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D010306:Parotid Gland / Q000601:surgery*; D011183:Postoperative Complications; D058996:Quality Improvement; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D014481:United States
keywords: NSQIP; mortality; outcomes; parotidectomy