Incidence of Multilevel Surgical Procedures and Readmissions in Uvulopalatopharyngoplasty in Taiwan
Journal
JAMA Otolaryngology - Head and Neck Surgery
Journal Volume
145
Journal Issue
9
Pages
803-810
Date Issued
2019
Author(s)
Abstract
Importance: Multilevel surgical procedures with uvulopalatopharyngoplasty (UPPP) appear to be associated with more complications than UPPP alone, but general and bleeding-related hospital readmissions have not been specifically investigated to date. Objective: To compare the risk of 30-day general and bleeding-related readmissions in adult patients who underwent UPPP alone and those who received a multilevel surgical procedure. Design, Setting, and Participants: This cross-sectional study retrospectively analyzed all cases of UPPP among adults (aged >20 years) in Taiwan from January 1, 2000, to December 31, 2012. Claims data in the Taiwan National Health Insurance Research Database were used. Participants were patients who underwent inpatient UPPP (n = 35029), and their basic information was acquired from the database. Data analyses were conducted from June 22, 2018, to August 22, 2018. Main Outcomes and Measures: The risks of major complications in patients who underwent UPPP alone, UPPP with nasal operation, and UPPP with tongue or hypopharyngeal operation were compared using a generalized linear mixed model. Results: In total, 35029 adults were identified (mean [SD] age of 39.2 [12.2] years, and 25 923 men [74.0%]). The proportion of UPPP concurrent with nasal operation increased from 2000 to 2012 (19.9% to 42.9%), as did that of UPPP with concurrent tongue or hypopharyngeal operation (2.7% to 5.2%). The rate of readmission for any reason after UPPP with nasal operation was higher than that for UPPP alone (4.7% vs 3.7%; adjusted odds ratio [aOR], 1.22; 95% CI, 1.09-1.37). The rate of readmission for any reason and readmission for bleeding for UPPP with tongue or hypopharyngeal operation (aOR, 1.68; 95% CI, 1.34-2.11) was also higher than that for UPPP alone (aOR, 2.34; 95% CI, 1.72-3.17). However, a multilevel surgical procedure was not associated with an increased risk of bleeding-related reoperation, regardless of the concurrent procedure. Conclusions and Relevance: The incidence of multilevel UPPP in Taiwan increased from 2000 to 2012, and these surgeries appeared to be associated with a higher risk of complications; results of this study suggest that these findings should be considered during surgical decision-making. ? 2019 American Medical Association. All rights reserved.
SDGs
Other Subjects
aminoglycoside; cephalosporin; hemostatic agent; macrolide; paracetamol; penicillin G potassium; steroid; adult; Article; cohort analysis; comparative study; controlled study; cross-sectional study; dehydration; dysgeusia; dysphagia; female; hospital readmission; hospitalization; human; hypernasality; ICD-9-CM; incidence; major clinical study; male; national health insurance; palatopharyngeal incompetence; perioperative period; postoperative hemorrhage; reimbursement; retrospective study; Taiwan; uvulopalatopharyngoplasty
Publisher
American Medical Association
Type
journal article