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Direct complications and routine ICU admission after total laryngectomy.

Rebecca Tosca Karsten ,
Adriana Jacquelina Timmermans ,
Julia Ten Cate ,
Martijn Matthias Stuiver ,
Michiel Wilhelmus Maria van den Brekel

Abstract

MATERIAL AND METHODS

Patients who underwent a TL in the NCI were reviewed on the occurrence of an event requiring ICU treatment within the first 24 hours postoperatively. The predictive value of predetermined risk factors was assessed with multivariable logistic analysis. The optimal threshold of the risk score assigned by the resulting model was determined.

CONCLUSIONS

A substantial proportion of the patients developed an event within the first 24 hours after TL. Our risk stratification of patients based on the mentioned risk factors is insufficiently accurate.

RESULTS

An event occurred in 25 of the 113 patients (22%) of which 72% included norepinephrine dependence. Risk analysis showed that patients with either CRT prior to TL or a procedure including pharynx reconstruction, or both, should be indicated for ICU stay. Applying the rule on this cohort, 57 patients (50%) would have been sent to the ward postoperatively of which seven (12%) developed an event requiring ICU treatment.

BACKGROUND

In the Netherlands Cancer Institute (NCI), patients are admitted to the Intensive Care Unit (ICU) after total laryngectomy (TL).

SIGNIFICANCE

The study provides an overview of direct postoperative complications after TL.

AIMS/OBJECTIVES

To assess direct complications and the need for ICU admission after TL.

More about this publication

Acta oto-laryngologica

Volume 138
Issue nr. 12
Pages 1128-1135
Publication date 01-12-2018

Full text links

Publisher website (DOI) 10.1080/00016489.2018.1515497
Europe PubMed Central 30686089
Pubmed 30686089

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