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Factors Precipitating Overnight Admission After Sialolithectomy
Fahad Rind1, Minka Schofield2, Ricardo L Carrau2
1Department of Otolaryngology, The Ohio State University OSUMC: The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Summary
Sialolithectomy patients requiring overnight admission were predicted by operative time, wound classification, and American Society of Anesthesiologists (ASA) Class 3. Endoscopic sialolithectomy showed longer operative times but potentially shorter lengths of stay.
Area of Science:
- Otolaryngology
- Surgical Outcomes Research
Background:
- Sialolithectomy is a procedure to remove salivary stones.
- Predicting the need for overnight admission after sialolithectomy is crucial for resource allocation and patient management.
Purpose of the Study:
- To identify perioperative factors that predict overnight admission following sialolithectomy.
- To compare outcomes between endoscopic (ES) and non-endoscopic (NES) sialolithectomy procedures.
Main Methods:
- Retrospective analysis of 916 sialolithectomy cases from the National Surgical Quality Improvement Program database (2007-2020).
- Utilized Current Procedural Terminology (CPT) codes for case identification and stratification into ES and NES groups.
- Multivariate analysis was performed to identify predictors of overnight admission (length of stay > 0 days).
Main Results:
- Overnight admission occurred in 13.7% of cases.
- Factors predicting overnight admission included Wound Class 4, American Society of Anesthesiologists (ASA) Class 3, and increased operative time.
- Wound Class 2 was associated with a lower risk of overnight admission.
- Endoscopic sialolithectomy cases had longer operative times compared to non-endoscopic procedures.
Conclusions:
- Intraoperative complexity, indicated by operative time, wound classification, and ASA Class 3, correlates with the need for admission after sialolithectomy.
- Endoscopic sialolithectomy, despite longer operative times, may offer benefits in terms of length of stay, warranting consideration within appropriate indications.
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