Benchmarks for Mortality, Morbidity, and Length of Stay for Head and Neck Surgical Procedures

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Abstract
AS PART of the ongoing trend toward ambulatory surgery, many otolaryngology procedures have shifted from the inpatient arena to the outpatient setting. The remaining procedures performed in the inpatient setting, therefore, tend to reflect more difficult or extensive procedures or a more ill patient population. Many of the procedures performed in the realm of head and neck oncology qualify on both fronts. Most patients with head and neck tumors present in the later decades of life and have risk factors for cardiopulmonary or vascular disease, usually in the setting of tobacco and/or alcohol use. This places them at higher risk for anesthesia, surgery, and postoperative complications. Preoperative counseling for these patients should include a discussion of such potential complications, and accurate counseling requires knowledge of the incidence and relative risks for such events. Several published reports1-5 have examined the incidence of various comorbidities and postoperative complications for patients with head and neck tumors. However, most of these studies are conducted within a single academic medical center and focus on specific patient populations or a select few complications. To determine reliable benchmarks, a large database of head and neck surgical procedures would need to be examined, sampling a wide range of institutions, thereby eliminating institutional and selection biases.