Factors Predictive of Postoperative Acute Respiratory Failure Following Inpatient Sinus Surgery

Ann Otol Rhinol Laryngol. 2018 Jul;127(7):429-438. doi: 10.1177/0003489418775129. Epub 2018 May 16.

Abstract

Objective: The impact of perioperative risk factors on outcomes following outpatient sinus surgery is well defined; however, risk factors and outcomes following inpatient surgery remain poorly understood. We aimed to define risk factors of postoperative acute respiratory failure following inpatient sinus surgery.

Methods: Utilizing data from the Nationwide Inpatient Sample Database from the years 2010 to 2014, we identified patients (≥18 years of age) with an Internal Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) procedure code of sinus surgery. We used multivariable logistic regression to identify risk factors of postoperative acute respiratory failure.

Results: We identified 4919 patients with a median age of 53 years. The rate of inpatient postoperative acute respiratory failure was 3.35%. Chronic sinusitis (57.7%) was the most common discharge diagnosis. The final multivariable logistic regression analysis suggested that pneumonia, bleeding disorder, alcohol dependence, nutritional deficiency, heart failure, paranasal fungal infections, and chronic kidney disease were associated with increased odds of acute respiratory failure (all P < .05).

Conclusion: To our knowledge, this represents the first study to evaluate potential risk factors of acute respiratory failure following inpatient sinus surgery. Knowledge of these risk factors may be used for risk stratification.

Keywords: adult; chronic rhinosinusitis; nationwide inpatient sample; perioperative risk factors; postoperative pulmonary complications; sinus surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adult
  • Humans
  • Incidence
  • Inpatients*
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / adverse effects*
  • Postoperative Complications*
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / etiology*
  • Retrospective Studies
  • Risk Assessment*
  • Risk Factors
  • Sinusitis / surgery*
  • United States / epidemiology