Volume 132, Issue 9 pp. 1707-1713

Original Reports

Complication Risk in Ventral Skull Base Surgery Based on Preoperative Hematocrit

Liam S. Flanagan BS,

Liam S. Flanagan BS

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Chris B. Choi BS,

Chris B. Choi BS

orcid.org/0000-0001-8380-8811

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Mehdi S. Lemdani BA,

Mehdi S. Lemdani BA

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Aakash Shah BS,

Aakash Shah BS

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Aksha Parray BA,

Aksha Parray BA

orcid.org/0000-0002-5368-1335

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Donata Sukyte-Raube MD,

Donata Sukyte-Raube MD

orcid.org/0000-0001-7239-1467

Center of Ear, Nose, and Throat Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania

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Christina H. Fang MD,

Christina H. Fang MD

orcid.org/0000-0001-6047-2788

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Soly Baredes MD, FACS,

Soly Baredes MD, FACS

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Jean Anderson Eloy MD, FARS, FACS,

Corresponding Author

Jean Anderson Eloy MD, FARS, FACS

[email protected]

orcid.org/0000-0003-2893-7818

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center–RWJBarnabas Health, Livingston, New Jersey, U.S.A.

Send correspondence to Jean Anderson Eloy, MD, FACS, FARS, Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, 90 Bergen St., Suite 8100, Newark, NJ 07103. E-mail: [email protected]

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Liam S. Flanagan BS,

Liam S. Flanagan BS

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Chris B. Choi BS,

Chris B. Choi BS

orcid.org/0000-0001-8380-8811

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Mehdi S. Lemdani BA,

Mehdi S. Lemdani BA

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Aakash Shah BS,

Aakash Shah BS

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Aksha Parray BA,

Aksha Parray BA

orcid.org/0000-0002-5368-1335

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Donata Sukyte-Raube MD,

Donata Sukyte-Raube MD

orcid.org/0000-0001-7239-1467

Center of Ear, Nose, and Throat Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania

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Christina H. Fang MD,

Christina H. Fang MD

orcid.org/0000-0001-6047-2788

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Soly Baredes MD, FACS,

Soly Baredes MD, FACS

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

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Jean Anderson Eloy MD, FARS, FACS,

Corresponding Author

Jean Anderson Eloy MD, FARS, FACS

[email protected]

orcid.org/0000-0003-2893-7818

Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center–RWJBarnabas Health, Livingston, New Jersey, U.S.A.

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First published: 13 October 2021

https://doi.org/10.1002/lary.29893

Editor's Note: This Manuscript was accepted for publication on September 22, 2021.

Presented as a Poster at the Triological Society 2021 Combined Sections Virtual Meeting, January 29–30, 2021.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

Preoperative anemia has been shown to be a predictor of complications in different surgeries. This has not been exclusively studied in skull base surgery. This study investigates the impact of preoperative hematocrit on complications following ventral skull base (VSB) surgery.

Study Design

Retrospective database review.

Methods

The National Surgical Quality Improvement Program was queried for all cases of VSB surgery from 2005 to 2015. Univariate and multivariate analyses were performed to investigate the impact of preoperative anemia on complications following VSB procedures.

Results

3,053 patients meeting inclusion criteria were identified. On univariate analysis, low hematocrit was found in 39.7% of patients and was associated with increased mean age (55.71 vs. 53.25 years), male gender (63.6% vs. 36.4%), and Black race (18.5% vs. 10.9%). Preoperative anemia was also associated with increased incidences of postoperative pneumonia, blood transfusions, sepsis, medical complications, surgical complications, extended length of hospital stay (LOS), and mortality. On multivariate analysis, associations between low preoperative hematocrit and perioperative transfusions (odds ratio [OR] 2.57, 95% confidence interval [CI] 1.88–3.50, P < .001), total surgical complications (OR 2.12, 95% CI 1.60–2.80, P < .001), and extended LOS (OR 1.29, 95% CI 1.05–1.57, P = .013) remained significant.

Conclusions

Low preoperative hematocrit is associated with increased risk of postoperative complications and extended LOS in patients undergoing VSB surgery. This study highlights the importance of careful preoperative assessment and management of anemia in these patients.

Level of Evidence

3 Laryngoscope, 132:1707–1713, 2022

Supporting Information

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Volume132, Issue9

September 2022

Pages 1707-1713

Complication Risk in Ventral Skull Base Surgery Based on Preoperative Hematocrit

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

Supporting Information

BIBLIOGRAPHY

References

Information

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Complication Risk in Ventral Skull Base Surgery Based on Preoperative Hematocrit

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

Supporting Information

BIBLIOGRAPHY

References

Related

Information