title: Predictors of adverse events after neck dissection: An analysis of the 2006-2011 National Surgical Quality Improvement Program (NSQIP) Database.
abstract: While neck dissection is an important primary and adjunctive procedure in the treatment of head and neck cancer, there is a paucity of studies evaluating outcomes. A retrospective review of the National Surgical Quality Improvement Program (NSQIP) database was performed to identify factors associated with adverse events (AEs) in patients undergoing neck dissection. A total of 619 patients were identified, using CPT codes specific to neck dissection. Of the 619 patients undergoing neck dissection, 142 (22.9%) experienced an AE within 30 days of the surgical procedure. Risk factors on multivariate regression analysis associated with increased AEs included dyspnea (odds ratio [OR] 2.57; 95% confidence interval [CI] 1.06 to 6.22; p = 0.037), previous cardiac surgery (OR 3.38; 95% CI 1.08 to 10.52; p = 0.036), increasing anesthesia time (OR 1.005; 95% CI 1 to 1.009; p = 0.036), and increasing total work relative value units (OR 1.09; CI 1.04 to 1.13; p < 0.001). The current study is the largest, most robust analysis to identify specific risk factors associated with AEs after neck dissection. This information will assist with preoperative optimization, patient counseling, and appropriate risk stratification, and it can serve as benchmarking for institutions comparing surgical outcomes.
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Umang
authors.initials: U
authors.lastname: Jain
authors.forename: Jessica
authors.initials: J
authors.lastname: Somerville
authors.forename: Sujata
authors.initials: S
authors.lastname: Saha
authors.forename: Jon P
authors.initials: JP
authors.lastname: Ver Halen
authors.forename: Anuja K
authors.initials: AK
authors.lastname: Antony
authors.forename: Sandeep
authors.initials: S
authors.lastname: Samant
authors.forename: John Y
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016208:Databases, Factual; D004417:Dyspnea / Q000150:complications; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection / Q000009:adverse effects* / Q000592:standards; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology*; D058996:Quality Improvement; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors