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Laryngoscope. 2019 Oct 23. doi: 10.1002/lary.28346. [Epub ahead of print]

Adult ambulatory otologic surgery: Unplanned revisits and complications.

Author information

1
University of California Irvine Medical Center Department of Otolaryngology, Orange, California, U.S.A.
2
Harvard Medical School, Boston, Massachusetts, U.S.A.

Abstract

OBJECTIVES:

Determine rates and reasons for unplanned revisits after ambulatory otologic surgery.

METHODS:

Cross-sectional analysis of State Ambulatory Surgery Databases of California, Florida, Iowa, and New York was performed for years 2010 and 2011. Ambulatory adult otology surgical procedures were linked to ambulatory, emergency, and inpatient databases for revisit encounters occurring within 30 days. The numbers of revisits and associated diagnoses were analyzed.

RESULTS:

A total of 16,709 ambulatory otologic cases were extracted (mean age, 50.3 years; 54.2% female). The most common primary procedures performed were tympanoplasty (n = 7,919), stapedectomy (n = 2504), cochlear implantation (n = 1444), tympanomastoidectomy (n = 713), and mastoidectomy (n = 697). The 30-day revisit rate was 5.2% (n = 875; 95% confidence interval [CI] 4.9%-5.6%). Urinary retention/urinary tract infection (UTI) (n = 93, 10.6%; CI 8.8%-12.9%) was the most common diagnosis at revisit, followed by otalgia (n = 85, 9.7% of revisits; CI: 7.9%-11.9%) and dizziness (n = 80, 9.1%; CI 7.4%-11.2%). Revisits most frequently occurred within the first 10 days postoperatively (47.2% of revisits), and a second revisit occurred 134 times (0.8% of cases). Fewer than 10 cases of facial nerve palsy were diagnosed (CI 0.03%-0.11%).

CONCLUSION:

With a relatively low unplanned revisit rate, ambulatory otologic surgery demonstrates a favorable safety profile. Common reasons for revisit included pain, urinary retention, and dizziness. Quality improvement measures should be directed at addressing these postoperative issues to minimize rates of complications and unplanned revisits.

LEVEL OF EVIDENCE:

NA Laryngoscope, 2019.

KEYWORDS:

Otology; ambulatory surgery; complications; revisits

PMID:
31643096
DOI:
10.1002/lary.28346

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