Impact of postoperative pneumonia following Pituitary surgery. (17th April 2015)

• Record Type: Journal Article
• Authors: Desai, Stuti V.; Fang, Christina H.; Raikundalia, Milap D.; Baredes, Soly; Liu, James K.; Eloy, Jean Anderson
• Is Part Of: Laryngoscope. Volume 125:Number 8(2015:Aug.)
• Page Start: 1792
• Page End: 1797
• Publication Date: 2015-04-17
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.25307
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary25307-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>Postoperative pneumonia (PNA) has been identified as a preventable <italic>never event</italic> by the Centers for Medicare and Medicaid Services (CMS). The CMS has discussed possibly discontinuing reimbursement for this postoperative complication. In this study, risk factors, patient outcomes, and hospital charges of care associated with postoperative PNA in patients undergoing pituitary surgery were evaluated.</p> </sec> <sec id="lary25307-sec-0002" sec-type="section"> <title>Methods</title> <p>Discharge data of patients who underwent pituitary surgery between 2002 and 2010 were obtained from the National Inpatient Sample database. Demographics, preexisting comorbidities, postoperative complications, morbidity, length of hospital stay, and hospital charges were analyzed.</p> </sec> <sec id="lary25307-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 15, 317 patients were included in this analysis. Ninety‐eight patients (0.6%) were diagnosed with PNA postoperatively. There was a significant association between postoperative PNA and older age (<italic>P</italic> < 0.001), male gender (<italic>P</italic> = 0.044), and transfrontal surgical approach (<italic>P</italic> < 0.001). Patients with anemia, congestive heart failure, chronic pulmonary disease, diabetes mellitus, fluid and electrolyte disorders, paralysis, and weight loss had a significantly higher rate of PNA. Patients with PNA had a significantly higher mortality (<italic>P</italic> < 0.001). They also incurred on average over four times the hospital charges and nearly five times longer hospitalizations compared to patients without PNA.</p> </sec> <sec id="lary25307-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Variables associated with an increased risk of postoperative PNA in patients undergoing pituitary surgery include older age, male gender, and transfrontal surgical approach. Patients with postoperative PNA had a longer length of hospital stay, higher hospital charges, and increased mortality.</p> </sec> <sec id="lary25307-sec-0005" sec-type="section"> <title>Level of Evidence</title> <p>2C. <italic>Laryngoscope</italic>, 125:1792–1797, 2015</p> </sec> </abstract>