TY - JOUR
T1 - Impact and cost of care of venous thromboembolism following pituitary surgery
AU - Spinazzi, Eleonora F.
AU - Pines, Morgan J.
AU - Fang, Christina H.
AU - Raikundalia, Milap D.
AU - Baredes, Soly
AU - Liu, James K.
AU - Eloy, Jean Anderson
N1 - Publisher Copyright:
© 2015 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Objectives/Hypothesis In 2008, the Centers for Medicare and Medicaid Services discontinued reimbursement for postoperative venous thromboembolism (VTE) events such as deep venous thrombosis and pulmonary embolism, citing them as preventable postoperative complications. We examined the impact of postoperative VTE on patients undergoing pituitary surgery. Methods The Nationwide Inpatient Sample (NIS) was evaluated for patients undergoing pituitary resection from 2002 to 2010. Patient demographics, comorbidities, length of stay, hospital charges, and postoperative complications were analyzed. Results Eighty-seven patients who underwent pituitary surgery developed a VTE. Patients who underwent pituitary surgery that developed VTE were older (55.9 ± 15.2 years) than those who did not develop VTE (50.1 ± 17.2 years) (P = 0.002). VTE occurred at a significantly higher rate in patients with coagulopathy, peripheral vascular disorder, and weight loss (P < 0.05). VTE was associated with increased rates of postoperative neurological, pulmonary, cardiac, urinary, renal, hemorrhage, fluid and electrolytes, diabetes insipidus, and cerebrospinal fluid rhinorrhea complications (P < 0.01) - as well as increased mortality rate (P < 0.001), length of stay (P < 0.001), and cost of care (P < 0.001). Conclusions Analysis of the data from the NIS database showed that risk factors for the development of VTE following pituitary surgery include older age, preexisting coagulopathy, peripheral vascular disorder, and weight loss. Patients who developed postoperative VTE had a longer length of hospital stay, higher hospital charges, and increased morbidity and mortality. Level of Evidence 2C.
AB - Objectives/Hypothesis In 2008, the Centers for Medicare and Medicaid Services discontinued reimbursement for postoperative venous thromboembolism (VTE) events such as deep venous thrombosis and pulmonary embolism, citing them as preventable postoperative complications. We examined the impact of postoperative VTE on patients undergoing pituitary surgery. Methods The Nationwide Inpatient Sample (NIS) was evaluated for patients undergoing pituitary resection from 2002 to 2010. Patient demographics, comorbidities, length of stay, hospital charges, and postoperative complications were analyzed. Results Eighty-seven patients who underwent pituitary surgery developed a VTE. Patients who underwent pituitary surgery that developed VTE were older (55.9 ± 15.2 years) than those who did not develop VTE (50.1 ± 17.2 years) (P = 0.002). VTE occurred at a significantly higher rate in patients with coagulopathy, peripheral vascular disorder, and weight loss (P < 0.05). VTE was associated with increased rates of postoperative neurological, pulmonary, cardiac, urinary, renal, hemorrhage, fluid and electrolytes, diabetes insipidus, and cerebrospinal fluid rhinorrhea complications (P < 0.01) - as well as increased mortality rate (P < 0.001), length of stay (P < 0.001), and cost of care (P < 0.001). Conclusions Analysis of the data from the NIS database showed that risk factors for the development of VTE following pituitary surgery include older age, preexisting coagulopathy, peripheral vascular disorder, and weight loss. Patients who developed postoperative VTE had a longer length of hospital stay, higher hospital charges, and increased morbidity and mortality. Level of Evidence 2C.
KW - Pituitary resection
KW - benign pituitary neoplasm
KW - deep venous thrombosis
KW - hospital complications
KW - nationwide inpatient sample
KW - pituitary tumor
KW - pulmonary embolism
KW - transfrontal
KW - transsphenoidal
KW - venous thromboembolism
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U2 - 10.1002/lary.25161
DO - 10.1002/lary.25161
M3 - Article
C2 - 25647758
AN - SCOPUS:84932197617
SN - 0023-852X
VL - 125
SP - 1563
EP - 1567
JO - Laryngoscope
JF - Laryngoscope
IS - 7
ER -