Prevalence and resource utilization for vocal fold paralysis/paresis after esophagectomy.
Journal Article
Objectives/hypothesis
Vocal fold paralysis/paresis (VFP) is an uncommon but serious complication following esophagectomy. The objectives of this study were to: 1) identify the prevalence of VFP and associated complications after esophagectomy in the United States, and 2) determine the utilization and otolaryngology-head and neck surgery/speech-language pathology (OHNS/SLP) and predictors of such utilization in the management of these patients.Study design
Retrospective database analysis.Methods
The National Inpatient Sample (NIS) represents a 20% stratified sample of discharges from US hospitals. Using International Classification of Diseases, Ninth Revision, Clinical Modification codes, patients undergoing esophagectomy between 2008 and 2013 were identified in the NIS. Subcohorts of patients with VFP and OHNS/SLP utilization were also identified. Weighted logistic regression models were used to compare binary outcomes such as complications; generalized linear models were used to compare total hospital charges and length of stay (LOS).Results
We studied 10,896 discharges, representing a weighted estimate of 52,610 patients undergoing esophagectomy. The incidence of VFP after esophagectomy was 1.96%. Compared to those without VFP, patients with VFP had a higher incidence of postoperative pneumonia, more medical complications, and were more likely to undergo tracheostomy; hospital charges and LOS were also higher. Of the patients with VFP, 35.0% received OHNS/SLP intervention.Conclusions
VFP after esophagectomy is associated with postoperative complications, prolonged LOS, and higher hospital costs. OHNS/SLP intervention occurred in roughly one-third of postesophagectomy VFP patients, suggesting there may be opportunities for enhanced evaluation and management of these patients.Level of evidence
4 Laryngoscope, 128:2815-2822, 2018.Full Text
Duke Authors
Cited Authors
- Crowson, MG; Tong, BC; Lee, H-J; Song, Y; Harpole, DH; Jones, HN; Cohen, S
Published Date
- December 2018
Published In
Volume / Issue
- 128 / 12
Start / End Page
- 2815 - 2822
PubMed ID
- 30229921
Pubmed Central ID
- 30229921
Electronic International Standard Serial Number (EISSN)
- 1531-4995
International Standard Serial Number (ISSN)
- 0023-852X
Digital Object Identifier (DOI)
- 10.1002/lary.27252
Language
- eng