Predictors of surgical complications in patients with sinonasal malignancy
| Autor: | Jatin P. Shah, Sonam Dodhia, Dauren Adilbay, Marc Cohen, Snehal G. Patel, Avery Yuan, Conall Fitzgerald, Ian Ganly, Jennifer R. Cracchiolo, Andrew T McLean, Richard J. Wong, Ximena Mimica, Piyush Gupta, Cristina Valero Mayor |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Adolescent Nose Neoplasms Subgroup analysis Malignancy Skull Base Neoplasms Article Young Adult Postoperative Complications medicine Humans Prospective Studies Child Aged Retrospective Studies Aged 80 and over business.industry Mortality rate Postoperative complication General Medicine Odds ratio Perioperative Middle Aged medicine.disease Prognosis Comorbidity Surgery Survival Rate Oncology Child Preschool Surgical Procedures Operative Female business Paranasal Sinus Neoplasms Follow-Up Studies |
| Zdroj: | J Surg Oncol |
| ISSN: | 1096-9098 |
| Popis: | Objectives Sinonasal and skull base tumors are rare, making it difficult to identify trends in surgical outcome. This study examines complications in a large cohort of patients undergoing surgery for sinonasal malignancy. Methods Following IRB approval, an institutional database was reviewed to identify patients who underwent surgery for sinonasal or skull base malignancies from 1973 to 2016 at our institution. Charlson comorbidity index score and Clavien-Dindo grade were calculated. The main study endpoint was subgroup analysis of Clavien-Dindo Grade 0, Grades 1-2, and Grades 3-5 complications. An ordinal logistic regression model was constructed to assess the association between comorbidities, demographics, tumor characteristics, and surgical complications. Results In total, 448 patients met inclusion criteria. Perioperative mortality rate at 30 days was 1.6% (n = 7). The rate of severe complications (Clavien-Dindo 3 or higher) was 13.6% (n = 61). Multivariate analysis using an ordinal logistic regression model showed no association between Charlson comorbidity index score and Clavien-Dindo grade of postoperative complication. Advanced T-stage was significantly associated with complications (p = 0.0014; odds ratio: 3.442 [95% confidence interval: 1.615, 7.338]). Conclusion Surgery for sinonasal and skull base tumors is safe with a low mortality rate. Advanced T-stage is associated with postoperative complications. These findings have implications for preoperative risk stratification. Key Points Surgery for sinonasal malignancy is safe with a 30 mortality of 1.6% and rate of severe complications of 12.8%. There is no association between patient comorbidity and post operative complication. On multivariate analysis, only advanced T stage was associated with increased rate of surgical complication. |
| Databáze: | OpenAIRE |
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