Risk stratification in endoscopic airway surgery: Is inpatient observation necessary?

Clint T. Allen, Chia Jung Lee, Tanya K. Meyer, Allen D. Hillel, Albert L. Merati

Research output: Contribution to journalArticle

Abstract

Purpose To compare post-operative complication rates between inpatient and outpatient endoscopic airway surgery in patients with laryngotracheal stenosis. Secondary objectives included characterization of a cohort of patients with this disease. Methods Retrospective review of patients with laryngotracheal stenosis in a tertiary care laryngology practice over a 5-year period. Results Ninety-one patients underwent 223 endoscopic airway surgeries. Of 114 outpatient interventions, 1 patient (0.8%) sought emergent medical care following discharge for respiratory distress. Of 109 procedures resulting in admission, no patients required transfer to a higher level of care, endotracheal intubation or placement of a surgical airway. There was no statistically significant difference in complication rates between patients treated as outpatients or inpatients (p = 0.33, chi square). There were no cardiopulmonary events. There were no pneumothoraces despite frequent use of jet ventilation. The most common etiologic category was idiopathic (58%), followed by granulomatosis with polyangiitis (16%) and history of tracheotomy (12%). Most patients with idiopathic disease were female (p < 0.001, Fisher's exact test). Conclusion Patients undergoing endoscopic surgery for airway stenosis rarely have post-operative complications, and outpatient surgery appears to be a safe alternative to post-operative admission and observation.

Original languageEnglish (US)
Pages (from-to)747-752
Number of pages6
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume35
Issue number6
DOIs
StatePublished - Nov 1 2014

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ASJC Scopus subject areas

  • Otorhinolaryngology

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