Prevalence and resource utilization for vocal fold paralysis/paresis after esophagectomy.

Abstract

Objectives/hypothesis

Vocal fold paralysis/paresis (VFP) is an uncommon but serious complication following esophagectomy. The objectives of this study were to: 1) identify the prevalence of VFP and associated complications after esophagectomy in the United States, and 2) determine the utilization and otolaryngology-head and neck surgery/speech-language pathology (OHNS/SLP) and predictors of such utilization in the management of these patients.

Study design

Retrospective database analysis.

Methods

The National Inpatient Sample (NIS) represents a 20% stratified sample of discharges from US hospitals. Using International Classification of Diseases, Ninth Revision, Clinical Modification codes, patients undergoing esophagectomy between 2008 and 2013 were identified in the NIS. Subcohorts of patients with VFP and OHNS/SLP utilization were also identified. Weighted logistic regression models were used to compare binary outcomes such as complications; generalized linear models were used to compare total hospital charges and length of stay (LOS).

Results

We studied 10,896 discharges, representing a weighted estimate of 52,610 patients undergoing esophagectomy. The incidence of VFP after esophagectomy was 1.96%. Compared to those without VFP, patients with VFP had a higher incidence of postoperative pneumonia, more medical complications, and were more likely to undergo tracheostomy; hospital charges and LOS were also higher. Of the patients with VFP, 35.0% received OHNS/SLP intervention.

Conclusions

VFP after esophagectomy is associated with postoperative complications, prolonged LOS, and higher hospital costs. OHNS/SLP intervention occurred in roughly one-third of postesophagectomy VFP patients, suggesting there may be opportunities for enhanced evaluation and management of these patients.

Level of evidence

4 Laryngoscope, 128:2815-2822, 2018.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1002/lary.27252

Publication Info

Crowson, Matthew G, Betty C Tong, Hui-Jie Lee, Yao Song, David H Harpole, Harrison N Jones and Seth Cohen (2018). Prevalence and resource utilization for vocal fold paralysis/paresis after esophagectomy. The Laryngoscope, 128(12). pp. 2815–2822. 10.1002/lary.27252 Retrieved from https://hdl.handle.net/10161/27292.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Tong

Betty Caroline Tong

Associate Professor of Surgery
Jones

Harrison N. Jones

Associate Professor of Head and Neck Surgery & Communication Sciences
Cohen

Seth Morris Cohen

Professor of Head and Neck Surgery & Communication Sciences

Dr. Cohen is an otolaryngologist head & neck surgeon with fellowship training in laryngology. He performs clinical care and research focused on patients with voice, airway, and swallowing problems. 


Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.