Comparison of tracheal resection outcomes at a university hospital vs county hospital setting
Abstract Objectives To evaluate the role of hospital setting on outcomes in open airway surgery by comparing patients who underwent surgery (cricotracheal resection [CTR] or tracheal resection [TR]) at a publicly funded county hospital vs a private university hospital. Methods Retrospective chart re...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-04-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.547 |
| _version_ | 1818849777718132736 |
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| author | Michael S. Chow Leonard Haller Tamara Chambers Lindsay Reder Karla O'Dell |
| author_facet | Michael S. Chow Leonard Haller Tamara Chambers Lindsay Reder Karla O'Dell |
| author_sort | Michael S. Chow |
| collection | DOAJ |
| description | Abstract Objectives To evaluate the role of hospital setting on outcomes in open airway surgery by comparing patients who underwent surgery (cricotracheal resection [CTR] or tracheal resection [TR]) at a publicly funded county hospital vs a private university hospital. Methods Retrospective chart review of patients undergoing CTR or TR at two institutions; a private university hospital and a publicly funded county hospital from September 2014 to September 2019. Length of intensive care unit (ICU) stay, total time to discharge, minor and major complications were the primary endpoints. Significance was defined as a P‐value less than .05. Results There were a total of 43 patients (17 county, 26 university) who had CTR or TR during the study period. Length of stay outcomes was reported as mean length of stay ± SD. There was a significant difference in ICU stay at the county hospital (7.17 (±5.36 days) compared to the university hospital (2.52 ± 1.85 days, P < .003) and a nearly significant total length of stay difference at the county hospital (12.4 ± 9.06 days) compared to the university hospital (7.84 ± 4 days, P < .072) There was overall a low incidence of complications but slightly more in the county compared to the university population. Conclusion Patients who underwent open airway surgery at the county hospital were more likely to have a longer ICU stay and slight increase in complications despite having a lower ASA (American Society of Anesthesiologists) classification and younger age. These outcomes are multifactorial and may be related to poorer access to primary care preoperatively leading to delay in diagnosis and treatment, poorly controlled or undiagnosed medical comorbidities, and differences in hospital resources. Level of Evidence IV. |
| first_indexed | 2024-12-19T06:38:38Z |
| format | Article |
| id | doaj.art-9da543e7be3241198caf1bf0ac098053 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-19T06:38:38Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-9da543e7be3241198caf1bf0ac0980532022-12-21T20:32:10ZengWileyLaryngoscope Investigative Otolaryngology2378-80382021-04-016227728210.1002/lio2.547Comparison of tracheal resection outcomes at a university hospital vs county hospital settingMichael S. Chow0Leonard Haller1Tamara Chambers2Lindsay Reder3Karla O'Dell4Department of Otolaryngology—Head and Neck Surgery New York University Grossman School of Medicine New York New York USAKeck School of Medicine of University of Southern California Los Angeles California USADepartment of Otolaryngology—Head and Neck Surgery University of Southern California Los Angeles California USAKaiser Permanente Baldwin Hills Los Angeles California USADepartment of Otolaryngology—Head and Neck Surgery University of Southern California Los Angeles California USAAbstract Objectives To evaluate the role of hospital setting on outcomes in open airway surgery by comparing patients who underwent surgery (cricotracheal resection [CTR] or tracheal resection [TR]) at a publicly funded county hospital vs a private university hospital. Methods Retrospective chart review of patients undergoing CTR or TR at two institutions; a private university hospital and a publicly funded county hospital from September 2014 to September 2019. Length of intensive care unit (ICU) stay, total time to discharge, minor and major complications were the primary endpoints. Significance was defined as a P‐value less than .05. Results There were a total of 43 patients (17 county, 26 university) who had CTR or TR during the study period. Length of stay outcomes was reported as mean length of stay ± SD. There was a significant difference in ICU stay at the county hospital (7.17 (±5.36 days) compared to the university hospital (2.52 ± 1.85 days, P < .003) and a nearly significant total length of stay difference at the county hospital (12.4 ± 9.06 days) compared to the university hospital (7.84 ± 4 days, P < .072) There was overall a low incidence of complications but slightly more in the county compared to the university population. Conclusion Patients who underwent open airway surgery at the county hospital were more likely to have a longer ICU stay and slight increase in complications despite having a lower ASA (American Society of Anesthesiologists) classification and younger age. These outcomes are multifactorial and may be related to poorer access to primary care preoperatively leading to delay in diagnosis and treatment, poorly controlled or undiagnosed medical comorbidities, and differences in hospital resources. Level of Evidence IV.https://doi.org/10.1002/lio2.547socioeconomic statussubglottic stenosistracheal resection |
| spellingShingle | Michael S. Chow Leonard Haller Tamara Chambers Lindsay Reder Karla O'Dell Comparison of tracheal resection outcomes at a university hospital vs county hospital setting Laryngoscope Investigative Otolaryngology socioeconomic status subglottic stenosis tracheal resection |
| title | Comparison of tracheal resection outcomes at a university hospital vs county hospital setting |
| title_full | Comparison of tracheal resection outcomes at a university hospital vs county hospital setting |
| title_fullStr | Comparison of tracheal resection outcomes at a university hospital vs county hospital setting |
| title_full_unstemmed | Comparison of tracheal resection outcomes at a university hospital vs county hospital setting |
| title_short | Comparison of tracheal resection outcomes at a university hospital vs county hospital setting |
| title_sort | comparison of tracheal resection outcomes at a university hospital vs county hospital setting |
| topic | socioeconomic status subglottic stenosis tracheal resection |
| url | https://doi.org/10.1002/lio2.547 |
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