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Neil Bhattacharyya, MD; Marvin P. Fried, MD

Arch Otolaryngol Head Neck Surg. 2001;127:127-132.

Objective  To determine benchmarks and factors that influence morbidity, mortality, and length of stay (LOS) for head and neck surgical procedures.

Methods  A specific database for head and neck surgical procedures was extracted from the National Hospital Data Survey database for 1995 through 1997. Records of inpatient admissions for patients undergoing head and neck surgery were examined to determine demographics, incidence of medical complications, mortality, and LOS. Data were statistically examined for the influence of medical complications on mortality and LOS.

Results  A total of 3932 patients underwent head and neck procedures. The overall medical morbidity and mortality rates were 5.65% and 2.98%, respectively. The presence of a major medical complication increased the odds of death by 5.65 (P<.001). Postoperative pneumonia was the most common medical complication (3.26%) and was associated with a mortality rate of 10.94% (odds ratio for mortality, 4.4). Acute myocardial infarction and stroke were rare (combined incidence, 1.86%) and were not statistically associated with increased mortality. Procedures that involved the esophagus carried the highest mortality rate (8.38%). The overall mean LOS was 6.15 days. This increased to 17.7 days when a major medical complication occurred (P<.001). Increasing age was associated with increased rates of medical complications and mortality (P<.001).

Conclusions  Medical complications in patients undergoing head and neck surgical procedures are associated with increased mortality rates and longer LOS. Mortality rates in head and neck surgery are low but may be improved by preventing medical complications.

From the Division of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (Dr Bhattacharyya); and Department of Otolaryngology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (Dr Fried).

Corresponding author and reprints: Neil Bhattacharyya, MD, Division of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, 333 Longwood Ave, Boston, MA 02115.

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