title: Postoperative complications of total laryngectomy in diabetic patients.
abstract: Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL.
  
  
  
  Retrospective analysis of surgical outcomes database METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software. Equal distribution of demographics and preoperative comorbidities was ensured between the diabetic and nondiabetic cohorts using a propensity-matching algorithm.
  
  
  
  Following propensity matching there were 495 TL patients included in this study. Among these, 110 (22.2%) were diabetic and 385 (77.8%) were nondiabetic. The only comorbidities associated with the diabetic cohort after matching were obesity, previous percutaneous coronary intervention, and hypertension. The rates of superficial surgical site infections were higher in the diabetic patient cohort (10.9% vs. 4.7%, P = .022). There were no significant differences in unplanned readmission (12.7% vs. 9.1%, P = .260), reoperation (14.3% vs. 15.1%, P = .864), and mortality (1.8% vs. 2.6%, P = 1.000) between the diabetic and the nondiabetic groups. Multivariate regression utilizing preoperative variables not accounted for by propensity matching showed that superficial surgical site infections were still higher in the diabetes cohort (odds ratio: 3.371, P = .021).
  
  
  
  Diabetic patients undergoing TL showed an increased incidence of superficial surgical site infections postoperatively. There were no other significant differences in readmission, reoperation, and mortality.
  
  
  
  4 Laryngoscope, 127:2247-2251, 2017.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Andrey
authors.initials: A
authors.lastname: Filimonov
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Jacob S
authors.initials: JS
authors.lastname: Brady
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Aparna
authors.initials: A
authors.lastname: Govindan
authors.affiliation: Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
authors.forename: Aziz
authors.initials: A
authors.lastname: Merchant
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
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.
authors.forename: Richard Chan Woo
authors.initials: RCW
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000601:surgery*; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data; D057216:Propensity Score; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D016896:Treatment Outcome
keywords: 30-day complications; National Surgical Quality Improvement Program; Otolaryngology; head and neck; morbidity and mortality; outcomes; readmissions