Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep;132(9):1707-1713.
doi: 10.1002/lary.29893. Epub 2021 Oct 13.

Complication Risk in Ventral Skull Base Surgery Based on Preoperative Hematocrit

Liam S Flanagan  1 , Chris B Choi  1 , Mehdi S Lemdani  1 , Aakash Shah  1 , Aksha Parray  1 , Donata Sukyte-Raube  2 , Christina H Fang  1 , Soly Baredes  1   3 , Jean Anderson Eloy  1   3   4   5   6
Affiliations

Complication Risk in Ventral Skull Base Surgery Based on Preoperative Hematocrit

Liam S Flanagan et al. Laryngoscope. 2022 Sep.

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.

Keywords: Ventral skull base; complication risk; head and neck surgery; hematocrit.

PubMed Disclaimer

References

BIBLIOGRAPHY

    1. Eloy JA, Vivero RJ, Hoang K, et al. Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base. Laryngoscope 2009;119:834-840.
    1. Bhatki AM, Carrau RL, Snyderman CH, Prevedello DM, Gardner PA, Kassam AB. Endonasal surgery of the ventral skull base-endoscopic transcranial surgery. Oral Maxillofac Surg Clin North Am 2010;22:157-168.
    1. Paluzzi A, Gardner P, Fernandez-Miranda JC, Snyderman C. The expanding role of endoscopic skull base surgery. Br J Neurosurg 2012;26:649-661.
    1. Lee JT, Kingdom TT, Smith TL, Setzen M, Brown S, Batra PS. Practice patterns in endoscopic skull base surgery: survey of the American Rhinologic Society. Int Forum Allergy Rhinol 2014;4:124-131.
    1. Kutlay M, Durmaz A, Özer İ, et al. Extended endoscopic endonasal approach to the ventral skull base lesions. Clin Neurol Neurosurg 2018;167:129-140.

LinkOut - more resources