title: Risk stratification in endoscopic airway surgery: is inpatient observation necessary?
abstract: OBJECTIVE
  To compare post-operative complication rates between inpatient and outpatient endoscopic airway surgery in patients with laryngotracheal stenosis. Secondary objectives included characterization of a cohort of patients with this disease.
  
  
  METHODS
  Retrospective review of patients with laryngotracheal stenosis in a tertiary care laryngology practice over a 5-year period.
  
  
  RESULTS
  Ninety-one patients underwent 223 endoscopic airway surgeries. Of 114 outpatient interventions, 1 patient (0.8%) sought emergent medical care following discharge for respiratory distress. Of 109 procedures resulting in admission, no patients required transfer to a higher level of care, endotracheal intubation or placement of a surgical airway. There was no statistically significant difference in complication rates between patients treated as outpatients or inpatients (p=0.33, chi square). There were no cardiopulmonary events. There were no pneumothoraces despite frequent use of jet ventilation. The most common etiologic category was idiopathic (58%), followed by granulomatosis with polyangiitis (16%) and history of tracheotomy (12%). Most patients with idiopathic disease were female (p<0.001, Fisher's exact test).
  
  
  CONCLUSIONS
  Patients undergoing endoscopic surgery for airway stenosis rarely have post-operative complications, and outpatient surgery appears to be a safe alternative to post-operative admission and observation.
authors.affiliation: Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA. Electronic address: callen60@jhmi.edu.
authors.forename: Clint T
authors.initials: CT
authors.lastname: Allen
authors.affiliation: Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Lee
authors.affiliation: Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA.
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Meyer
authors.affiliation: Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA.
authors.forename: Allen D
authors.initials: AD
authors.lastname: Hillel
authors.affiliation: Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA.
authors.forename: Albert L
authors.initials: AL
authors.lastname: Merati
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006760:Hospitalization; D006801:Humans; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D014135:Tracheal Stenosis / Q000601:surgery*