Total laryngectomy and readmission: causes, rates and predictors

Area of Science:

• Otolaryngology
• Surgical Oncology
• Health Services Research

Background:

• Total laryngectomy (TL) is a complex surgical procedure associated with a high risk of hospital readmission.
• Hospital readmissions post-TL can lead to complications and indicate quality of care issues.
• Understanding readmission patterns is crucial for improving patient outcomes after TL.

Purpose of the Study:

• To determine the incidence of hospital readmission within 60 days following total laryngectomy.
• To identify the primary causes contributing to readmission after TL.
• To pinpoint significant predictors associated with increased risk of readmission post-TL.

Main Methods:

• A retrospective study was conducted over 12 years (2008-2022) at a single tertiary care center.
• Included all patients who underwent total laryngectomy (TL).
• Patient medical records were analyzed for demographics, comorbidities, and reasons for readmission.

Main Results:

• Out of 83 patients, 12 (14.50%) experienced readmission within 60 days post-discharge.
• The most common causes for readmission were surgical site infection (33.33%) and mucocutaneous fistula (25%).
• Key predictors for readmission included tobacco use, African ethnicity, being unmarried, lower preoperative serum albumin, higher TSH, higher neutrophil count, higher ASA score, and higher CIRS score.

Conclusions:

• Approximately one in seven patients undergoing TL are readmitted within 60 days.
• Wound infections and fistulas are frequent causes of readmission.
• Preoperative factors such as hypoalbuminemia, hypothyroidism, tobacco use, ethnicity, marital status, and comorbidity burden predict readmission risk.