title: Impact of chronic obstructive pulmonary disease on patients undergoing laryngectomy for laryngeal cancer.
abstract: Although chronic obstructive pulmonary disease (COPD) is a common comorbidity in patients undergoing laryngeal cancer surgery, the impact of this comorbidity in this setting is not well established. In this analysis, we used the Nationwide Inpatient Sample (NIS) to elucidate the impact of COPD on outcomes after laryngectomy for laryngeal cancer.
  
  
  
  The NIS was queried for patients admitted from 1998 to 2010 with laryngeal cancer who underwent total or partial laryngectomy. Patient demographics, type of admission, length of stay, hospital charges, and concomitant diagnoses were analyzed.
  
  
  
  Our inclusion criteria yielded a cohort of 40,441 patients: 3,051 with COPD and 37,390 without. On average, COPD was associated with an additional $12,500 (P < 0.001) in hospital charges and an additional 1.4 days (P < 0.001) of hospital stay. There was no significant difference in incidence of in-hospital mortality between the COPD and non-COPD groups after total laryngectomy (1.1% in COPD vs. 1.0% in non-COPD; P = 0.776); however, there was an increased incidence of in-hospital mortality in the COPD group compared to the non-COPD group after partial laryngectomy (3.4% in COPD vs. 0.4% in non-COPD; P < 0.001). Multivariate adjusted logistic regression revealed that COPD was associated with greater odds of pulmonary complications after both partial laryngectomy (odds ratio [OR] = 3.198; P < 0.001) and total laryngectomy (OR = 1.575; P < 0.001).
  
  
  
  Chronic obstructive pulmonary disease appears to be associated with greater hospital charges, length of stay, and postoperative pulmonary complications in patients undergoing laryngectomy for laryngeal cancer. Chronic obstructive pulmonary disease after partial, but not total, laryngectomy appears to be associated with increased risk of in-hospital mortality.
  
  
  
  2C. Laryngoscope, 2016 127:417-423, 2017.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sylvester
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Emily
authors.initials: E
authors.lastname: Marchiano
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Richard Chan Woo
authors.initials: RC
authors.lastname: Park
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.|Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007822:Laryngeal Neoplasms / Q000191:economics / Q000601:surgery*; D007825:Laryngectomy / Q000191:economics / Q000401:mortality; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000401:mortality; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000191:economics / Q000401:mortality; D012307:Risk Factors
keywords: Chronic obstructive pulmonary disease (COPD); Nationwide Inpatient Sample (NIS); laryngeal cancer; partial laryngectomy; postoperative pulmonary complications; total laryngectomy