TY - JOUR
T1 - Impact of postoperative pneumonia following Pituitary surgery
AU - Desai, Stuti V.
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 - 2015/8/1
Y1 - 2015/8/1
N2 - Objectives/Hypothesis Postoperative pneumonia (PNA) has been identified as a preventable never event by the Centers for Medicare and Medicaid Services (CMS). The CMS has discussed possibly discontinuing reimbursement for this postoperative complication. In this study, risk factors, patient outcomes, and hospital charges of care associated with postoperative PNA in patients undergoing pituitary surgery were evaluated. Methods Discharge data of patients who underwent pituitary surgery between 2002 and 2010 were obtained from the National Inpatient Sample database. Demographics, preexisting comorbidities, postoperative complications, morbidity, length of hospital stay, and hospital charges were analyzed. Results A total of 15,317 patients were included in this analysis. Ninety-eight patients (0.6%) were diagnosed with PNA postoperatively. There was a significant association between postoperative PNA and older age (P < 0.001), male gender (P = 0.044), and transfrontal surgical approach (P < 0.001). Patients with anemia, congestive heart failure, chronic pulmonary disease, diabetes mellitus, fluid and electrolyte disorders, paralysis, and weight loss had a significantly higher rate of PNA. Patients with PNA had a significantly higher mortality (P < 0.001). They also incurred on average over four times the hospital charges and nearly five times longer hospitalizations compared to patients without PNA. Conclusions Variables associated with an increased risk of postoperative PNA in patients undergoing pituitary surgery include older age, male gender, and transfrontal surgical approach. Patients with postoperative PNA had a longer length of hospital stay, higher hospital charges, and increased mortality.
AB - Objectives/Hypothesis Postoperative pneumonia (PNA) has been identified as a preventable never event by the Centers for Medicare and Medicaid Services (CMS). The CMS has discussed possibly discontinuing reimbursement for this postoperative complication. In this study, risk factors, patient outcomes, and hospital charges of care associated with postoperative PNA in patients undergoing pituitary surgery were evaluated. Methods Discharge data of patients who underwent pituitary surgery between 2002 and 2010 were obtained from the National Inpatient Sample database. Demographics, preexisting comorbidities, postoperative complications, morbidity, length of hospital stay, and hospital charges were analyzed. Results A total of 15,317 patients were included in this analysis. Ninety-eight patients (0.6%) were diagnosed with PNA postoperatively. There was a significant association between postoperative PNA and older age (P < 0.001), male gender (P = 0.044), and transfrontal surgical approach (P < 0.001). Patients with anemia, congestive heart failure, chronic pulmonary disease, diabetes mellitus, fluid and electrolyte disorders, paralysis, and weight loss had a significantly higher rate of PNA. Patients with PNA had a significantly higher mortality (P < 0.001). They also incurred on average over four times the hospital charges and nearly five times longer hospitalizations compared to patients without PNA. Conclusions Variables associated with an increased risk of postoperative PNA in patients undergoing pituitary surgery include older age, male gender, and transfrontal surgical approach. Patients with postoperative PNA had a longer length of hospital stay, higher hospital charges, and increased mortality.
KW - Pituitary surgery
KW - aspiration pneumonia
KW - benign pituitary neoplasm
KW - hospital complications
KW - infectious pneumonia
KW - nationwide inpatient sample
KW - pituitary tumor
KW - transfrontal
KW - transsphenoidal
KW - ventilator-associated pneumonia
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U2 - 10.1002/lary.25307
DO - 10.1002/lary.25307
M3 - Article
C2 - 25892492
AN - SCOPUS:84937516774
SN - 0023-852X
VL - 125
SP - 1792
EP - 1797
JO - Laryngoscope
JF - Laryngoscope
IS - 8
ER -