https://scholars.lib.ntu.edu.tw/handle/123456789/587070
Title: | Association of cumulative surgeon volume and risk of complications in adult uvulopalatopharyngoplasty: A population-based study in Taiwan | Authors: | Hsu Y.-S. WEI-CHUNG HSU JENQ-YUH KO TE-HUEI YEH Lee C.-H. Kang K.-T. |
Issue Date: | 2020 | Publisher: | American Academy of Sleep Medicine | Journal Volume: | 16 | Journal Issue: | 3 | Start page/Pages: | 423-430 | Source: | Journal of Clinical Sleep Medicine | Abstract: | Study Objectives: Patients with obstructive sleep apnea undergoing upper airway surgery are known to have an increased perioperative risk, however, the effect of surgeon volume on this risk is largely unknown. We compared the 30-day readmission, bleeding, and mortality rates in adult patients with obstructive sleep apnea undergoing uvulopalatopharyngoplasty by cumulative surgeon volume. The objective of this study is to compare the risks of complications among different cumulative surgeon volume groups in adult patients undergoing uvulopalatopharyngoplasty and multilevel surgery. Methods: In this retrospective study, data of all adult inpatients (aged older than 18 years) who underwent uvulopalatopharyngoplasty in Taiwan between 2000 and 2012 were identified from the National Health Insurance Research Database and then analyzed. Using mixed-effect logistic regression, we compared the risks of major complications in patients undergoing uvulopalatopharyngoplasty alone, uvulopalatopharyngoplasty with nasal surgery, and uvulopalatopharyngoplasty with tongue or hypopharyngeal surgery according to groups of cumulative surgeon volume (divided into four quartiles). Results: A total of 36,483 adults were identified (mean age, 38.6 years; 73.7% men). When quartile 4 was used as reference, very low surgeon volume (quartile 1) was associated with higher risks of readmission within 30 days (adjusted odds ratio [aOR] 1.35, 95% confidence interval [CI] 1.17-1.57, P <.001), in-hospital death (aOR, 6.14, 95% CI 1.33-28.27, P = .020), and 30-day mortality (aOR, 4.90, 95% CI 1.83-13.09, P = .002). Conclusions: Higher complication rates in uvulopalatopharyngoplasty appear to be associated with very low cumulative surgeon volume. ? 2020 American Academy of Sleep Medicine. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85082146993&doi=10.5664%2fJCSM.8222&partnerID=40&md5=3c375fe9e0d6881a8ccecb02fe115502 https://scholars.lib.ntu.edu.tw/handle/123456789/587070 |
ISSN: | 1550-9389 | DOI: | 10.5664/JCSM.8222 | SDG/Keyword: | adult; aged; Article; cross-sectional study; ear nose throat surgery; female; high volume surgeon; hospital mortality; hospital readmission; human; hypopharyngeal surgery; low volume surgeon; major clinical study; male; middle aged; mortality rate; nose surgery; population research; postoperative complication; retrospective study; sleep disordered breathing; Taiwan; tongue surgery; uvulopalatopharyngoplasty; young adult; postoperative complication; surgeon; surgery; uvula; Adult; Aged; Female; Hospital Mortality; Humans; Male; Postoperative Complications; Retrospective Studies; Surgeons; Taiwan; Uvula |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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