TY - JOUR
T1 - Neck hematoma after major head and neck surgery
T2 - Risk factors, costs, and resource utilization
AU - Shah-Becker, Shivani
AU - Greenleaf, Erin K.
AU - Boltz, Melissa
AU - Hollenbeak, Christopher S.
AU - Goyal, Neerav
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/6
Y1 - 2018/6
N2 - Background: Postoperative cervical hematoma after major head and neck surgery is a feared complication. However, risk factors for developing this complication and attributable costs are not well-established. Methods: The Nationwide Inpatient Sample database was utilized compare patients with and without postoperative cervical hematoma. Logistic regression was used to analyze risk factors for hematoma formation and 30-day mortality. Total inpatient length of stay (LOS) and costs were fit to generalized linear models. Results: Of 32 071 patients, 1098 (3.4%) experienced a postoperative cervical hematoma. Male sex (odds ratio [OR] 1.38; P <.0001), black race (OR 1.35; P =.010), 4 or more comorbidities (OR 1.66; P <.0001), or presence of a preoperative coagulopathy (OR 6.76; P <.0001) were associated. Postoperative cervical hematoma was associated with 540% increased odds of death (P <.0001). The LOS and total excess costs were 5.14 days (P <.0001) and $17 887.40 (P <.0001), respectively. Conclusion: Although uncommon, postoperative cervical hematoma is a life-threatening complication of head and neck surgery with significant implications for outcomes and resource utilization.
AB - Background: Postoperative cervical hematoma after major head and neck surgery is a feared complication. However, risk factors for developing this complication and attributable costs are not well-established. Methods: The Nationwide Inpatient Sample database was utilized compare patients with and without postoperative cervical hematoma. Logistic regression was used to analyze risk factors for hematoma formation and 30-day mortality. Total inpatient length of stay (LOS) and costs were fit to generalized linear models. Results: Of 32 071 patients, 1098 (3.4%) experienced a postoperative cervical hematoma. Male sex (odds ratio [OR] 1.38; P <.0001), black race (OR 1.35; P =.010), 4 or more comorbidities (OR 1.66; P <.0001), or presence of a preoperative coagulopathy (OR 6.76; P <.0001) were associated. Postoperative cervical hematoma was associated with 540% increased odds of death (P <.0001). The LOS and total excess costs were 5.14 days (P <.0001) and $17 887.40 (P <.0001), respectively. Conclusion: Although uncommon, postoperative cervical hematoma is a life-threatening complication of head and neck surgery with significant implications for outcomes and resource utilization.
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U2 - 10.1002/hed.25102
DO - 10.1002/hed.25102
M3 - Article
C2 - 29607559
AN - SCOPUS:85044788245
SN - 1043-3074
VL - 40
SP - 1219
EP - 1227
JO - Head and Neck
JF - Head and Neck
IS - 6
ER -