Rate and Factors Associated With Change in Surgeon for Revision Endoscopic Sinus Surgery.

Jafari, Aria; Panuganti, Bharat A; Crawford, Kayva L; Shen, Sarek; DeConde, Adam S

Jafari, Aria; Panuganti, Bharat A; Crawford, Kayva L; Shen, Sarek; DeConde, Adam S.

Afiliación

Jafari A; Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, University of Washington, Seattle, Washington, U.S.A.
Panuganti BA; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A.
Crawford KL; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A.
Shen S; School of Medicine, University of California San Diego, La Jolla, California, U.S.A.
DeConde AS; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A.

Laryngoscope ; 131(4): E1049-E1053, 2021 04.

Article en En | MEDLINE | ID: mdl-32866287

RESUMEN

OBJECTIVES/HYPOTHESIS: A subset of patients will undergo revision endoscopic sinus surgery (ESS) with a different otolaryngologist than the one who performed their primary surgery. The purpose of this study is to report the incidence of and clinicodemographic factors associated with a change in surgeon for revision ESS. STUDY DESIGN: Retrospective cohort study. METHODS: Adult patients who underwent at least two outpatient ESS procedures between 2009 and 2014 using the State Ambulatory Surgery Database for Florida were included in the study. Change in surgeon was defined by a change in a unique provider identifier for the revision procedure. Multivariable regression analysis was used to determine characteristics associated with a change in surgeon. RESULTS: A total of 2,963 patients were included. For the revision procedure, 47.7% of patients changed their surgeon. On multivariable logistic regression, a medium- (odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.53-0.77) or high-volume (OR: 0.50; 95% CI: 0.42-0.61) surgeon performing the index surgery and advanced age (≥65 years) (OR: 0.79; 95% CI: 0.63-0.99) were associated with decreased odds of surgeon change for revision ESS. Longer time elapsed between index and revision surgery (OR: 1.15; 95% CI: 1.13-1.17) was associated with increased odds of surgeon change. CONCLUSIONS: Nearly half of patients who undergo revision ESS select a surgeon other than the one who performed their primary procedure. Surgeon volume, age, and time between surgeries affect the likelihood of a change in surgeon for revision ESS. These findings may provide introductory insights into patient preferences and decision making in the surgical management of recalcitrant chronic rhinosinusitis. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E1049-E1053, 2021.

Asunto(s)

Endoscopía/métodos; Enfermedades de los Senos Paranasales/cirugía; Cirujanos; Adolescente; Adulto; Anciano; Femenino; Florida; Humanos; Masculino; Persona de Mediana Edad; Reoperación; Estudios Retrospectivos

Palabras clave

Endoscopic sinus surgery; continuity of care; patient retention; patient satisfaction; population research; revision endoscopic sinus surgery

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de los Senos Paranasales / Endoscopía / Cirujanos Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Laryngoscope Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

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