Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures

Objectives/Hypothesis Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS). Study Design Retrospective cohort analysis. Methods An an...

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Bibliographic Details
Published in:The Laryngoscope 2020-12, Vol.130 (12), p.E837-E842
Main Authors: Lebo, Nicole L., Quimby, Alexandra E., Caulley, Lisa, Thavorn, Kednapa, Kekre, Natasha, Brode, Sarah, Johnson‐Obaseki, Stephanie
Format: Article
Language:English
Subjects:
Aged
Cohort Studies
Female
Head - surgery
head and neck surgery
Humans
Infections
length of stay
Length of Stay - statistics & numerical data
Male
Maxillofacial surgery
Middle Aged
Neck - surgery
Quality control
quality improvement
Retrospective Studies
Surgical outcomes
Surgical site infection
Surgical site infections
Surgical Wound Infection - epidemiology
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Summary:Objectives/Hypothesis Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS). Study Design Retrospective cohort analysis. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement Program was undertaken. All adult patients undergoing complex HNS from 2005 to 2016 were included in the analysis. Our main outcomes were SSI incidence and increase in hospital LOS attributable to SSI. Results Of 4,014 patients identified, 16.5% developed SSI. History of smoking, diabetes, preoperative wound infection, contaminated or dirty wound classes, and prolonged operative time were found to significantly predict postoperative SSI. Adjusting for significant pre‐ and postoperative factors, SSI was associated with significantly increased LOS (hazard ratio = 0.486, 95% confidence interval: 0.419‐0.522). Conclusions SSI following complex HNS is associated with significantly increased hospital LOS. This result supports the need for institutional QI strategies that target SSIs after head and neck procedures in an effort to provide the highest quality care at the lowest possible cost. Our analysis identifies risk factors that can allow identification of patients at high risk of SSI and prolonged hospitalization. Level of Evidence 2b Laryngoscope, 2020
ISSN:0023-852X
1531-4995
1531-4995
DOI:10.1002/lary.28512