National Trends in Vestibular Schwannoma Surgery: Influence of Patient Characteristics on Outcomes. (July 2018)

• Record Type: Journal Article
• Authors: Hatch, Jonathan L.; Bauschard, Michael J.; Nguyen, Shaun A.; Lambert, Paul R.; Meyer, Ted A.; McRackan, Theodore R.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 159:Number 1(2018)
• Page Start: 102
• Page End: 109
• Publication Date: 2018-07
• Subjects: vestibular schwannoma -- quality improvement -- facial nerve -- postoperative complications; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599818765717
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To characterize current vestibular schwannoma (VS) surgery outcomes with a nationwide database and identify factors associated with increased complications and prolonged hospital course. Study Design: Retrospective review utilizing the University HealthSystem Consortium national inpatient database. Setting: US academic health centers. Subjects and Methods: Data from patients undergoing VS surgery were analyzed over a 3-year time span (October 2012 to September 2015). Surgical outcomes, such as length of stay (LOS), complications, and mortality, were analyzed on the basis of race, sex, age, and comorbidities during the 30-day postoperative period. Results: A total of 3697 VS surgical cases were identified. The overall mortality rate was 0.38%, and the overall complication rate was 5.3%. Advanced age significantly affected intensive care unit LOS, mortality, and complications ( P = .04). Comorbidities, including hypertension, obesity, and depression, also significantly increased complication rates ( P = .02). Sixty-eight patients (1.8%) had a history of irradiation, and they had a significantly increased LOS ( P = .03). Conclusion: Modern VS surgery has a low mortality rate and a relatively low rate of complications. Several factors contribute to high complication rates, including age and comorbidities. These data will help providers in counseling patients on which treatment course might be best suited for them.