Safety of Superficial Parotidectomy in Elderly Patients: Insights from
the National Surgical Quality Improvement Program
Abstract
Objectives Superficial parotidectomy is a common surgery
performed by Otolaryngologists. Elderly patients may be undertreated due
to perceived complications. Our study aimed to evaluate the differences
in early postoperative outcomes in patients over age 75.
Methods The National Surgical Quality Improvement (NSQIP)
database identified patients undergoing superficial parotidectomy.
Cohorts were created for patients younger and older than 75. Bivariate
and multivariate analyses compared rates of postoperative complications,
reoperation, length of stay and readmission. Subgroup analyses were
conducted for benign and malignant disease. Results Our query
identified 2472 patients, including 309 elderly and 2163 younger
patients. Bivariate analysis showed significantly higher rates of stroke
(p = 0.043), readmission (p < 0.001), hospital stay longer
than two days (p < 0.001) and need for transfusion (p = 0.026)
in elderly patients. On multivariate analsysis, readmission rates (OR:
2.648, 95% CI: 1.035-6.775, p = 0.042) and increased length of stay
(OR: 2.405, 95% CI: 1.348-4.298, p = 0.003) were significantly worse in
elderly patients. Subgroup analysis showed that elderly patients treated
for malignant parotid tumors were more likely to be readmitted (OR:
6.928, 95% CI: 1.293-37.111, p = 0.024). Conclusion
Superficial parotidectomy appears to be a safe when performed in elderly
patients. Main risks to consider in this population include readmission
and increased hospital length of stay. Major postoperative morbidities
were not identified on multivariate analysis.