National Trends in 30-Day Readmission Following Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma.
| Title: | National Trends in 30-Day Readmission Following Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma. |
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| Authors: | Nyirjesy SC; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; McCrary HC; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Zhao S; Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University College of Medicine, Columbus.; Judd RT; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Farlow JL; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Seim NB; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Ozer E; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Agrawal A; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Old MO; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Rocco JW; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Kang SY; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; Haring CT; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus.; The James Cancer Hospital and Solove Research Institute, Columbus, Ohio. |
| Source: | JAMA otolaryngology-- head & neck surgery [JAMA Otolaryngol Head Neck Surg] 2024 Feb 01; Vol. 150 (2), pp. 133-141. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101589542 Publication Model: Print Cited Medium: Internet ISSN: 2168-619X (Electronic) Linking ISSN: 21686181 NLM ISO Abbreviation: JAMA Otolaryngol Head Neck Surg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Chicago, IL : American Medical Association, [2013]- |
| MeSH Terms: | Carcinoma, Squamous Cell*/pathology ; Robotic Surgical Procedures*/adverse effects ; Oropharyngeal Neoplasms* ; Head and Neck Neoplasms*; Humans ; Male ; Middle Aged ; Adolescent ; Female ; Squamous Cell Carcinoma of Head and Neck ; Patient Readmission ; Cohort Studies ; Retrospective Studies ; Electrolytes |
| Abstract: | Importance: As the incidence of oropharyngeal squamous cell carcinoma (OPSCC) continues to rise in the US, an increasing number of patients are being treated with transoral robotic surgery (TORS). Readmission following surgery can potentially delay initiation of adjuvant treatment and affect survival outcomes.; Objective: To identify risk factors for 30-day postoperative readmission in patients undergoing TORS for OPSCC.; Design, Setting, and Participants: This retrospective, population-based cohort study used data from the Nationwide Readmissions Database from 2010 to 2017. All patients undergoing TORS for OPSCC were identified using International Classification of Diseases codes and included. Exclusion criteria were age younger than 18 years or incomplete information regarding index admission or readmission. The analysis was performed from April to October 2023.; Exposure: TORS for OPSCC.; Main Outcomes and Measures: Univariate and multivariate analyses were performed to determine factors associated with 30-day readmission. Covariates included demographics and medical comorbidities, socioeconomic factors, hospital characteristics, and surgical details. Trends in readmission over time, reasons for readmission, and characteristics of the readmission were also examined.; Results: A weighted total of 5544 patients (mean [SD] age, 60.7 [0.25] years; 4475 [80.7%] male) underwent TORS for OPSCC. The overall readmission rate was 17.5% (n = 971), and these rates decreased over the study period (50 of 211 patients [23.7%] in 2010 vs 58 of 633 patients [9.1%] in 2017). Risk factors associated with readmission included male sex (adjusted odds ratio [AOR], 1.54; 95% CI, 1.07-2.20) and a diagnosis of congestive heart failure (AOR, 2.42; 95% CI, 1.28-4.58). Factors associated with decreased rate of readmission included undergoing concurrent selective neck dissection (AOR, 0.30; 95% CI, 0.22-0.41). Among the 971 readmissions, the most common readmission diagnoses were bleeding (151 [15.6%]), electrolyte and digestive problems (44 [4.5%]), pneumonia (44 [4.5%]), and sepsis (26 [2.7%]).; Conclusions and Relevance: In this cohort study, readmission rates following TORS for oropharynx cancer decreased over time; however, a subset of patients required readmission most commonly related to bleeding, infection, and electrolyte imbalance. Concurrent neck dissection may be protective against readmission. Elucidation of risk factors for readmission after TORS for OPSCC offers opportunities for evidence-based shared decision-making, quality improvement initiatives, and improved patient counseling. |
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| Substance Nomenclature: | 0 (Electrolytes) |
| Entry Date(s): | Date Created: 20231228 Date Completed: 20240209 Latest Revision: 20250104 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10853828 |
| DOI: | 10.1001/jamaoto.2023.4025 |
| PMID: | 38153724 |
| Database: | MEDLINE |
Journal Article