Neck hematoma after major head and neck surgery: Risk factors, costs, and resource utilization

作者：Shah Becker Shivani; Greenleaf Erin K; Boltz Melissa M; Hollenbeak Christopher S; Goyal Neerav^*

来源：Head and Neck-Journal for the Sciences and Specialties of the Head and Neck, 2018, 40(6): 1219-1227.

DOI：10.1002/hed.25102

• head and neck cancer
• length of stay
• postoperative cervical hematoma
• postoperative neck hematoma
• risk factors

BackgroundPostoperative cervical hematoma after major head and neck surgery is a feared complication. However, risk factors for developing this complication and attributable costs are not well-established.
MethodsThe Nationwide Inpatient Sample database was utilized compare patients with and without postoperative cervical hematoma. Logistic regression was used to analyze risk factors for hematoma formation and 30-day mortality. Total inpatient length of stay (LOS) and costs were fit to generalized linear models.
ResultsOf 32071 patients, 1098 (3.4%) experienced a postoperative cervical hematoma. Male sex (odds ratio [OR] 1.38; P<.0001), black race (OR 1.35; P=.010), 4 or more comorbidities (OR 1.66; P<.0001), or presence of a preoperative coagulopathy (OR 6.76; P<.0001) were associated. Postoperative cervical hematoma was associated with 540% increased odds of death (P<.0001). The LOS and total excess costs were 5.14 days (P<.0001) and $17887.40 (P<.0001), respectively.
ConclusionAlthough uncommon, postoperative cervical hematoma is a life-threatening complication of head and neck surgery with significant implications for outcomes and resource utilization.

• 出版日期2018-6