Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P114

PSQI

P114		
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
The survey was self-administered through email delivery to
transmission across mucous membranes. A readily accessible
practicing physician members of the American Academy of
document allowed for immediate information sharing and
Otolaryngology-Head and Neck Surgery.
guidance during this time of the unknown. This demonstrates
Results: There were 349 respondents who were primarily
the importance of quick dissemination of multi-institutional
attending physicians in private practice and used SCs 25% to
data to help create dialogue and facilitate directing policies at
50% of the time. SC use was more prevalent in the Southeast
our own institutions during a crisis.
United States (adjusted odds ratio [aOR], 2.10; 95% CI, 1.18-
3.72) and by those in private practice (aOR, 2.67; 95% CI,
Comparison of Outpatient Versus Inpatient
1.63-4.37). Knowledge did not vary across respondents; howParathyroidectomy: An ACS NSQIP Analysis
ever, lack of knowledge was associated with increased use.
Ishwarya Shradha Mamidi (Presenter); Daniel A. Benito, MD;
Only 62.8% of respondents answered all 4 knowledge quesRyan Lee; Arjun S. Joshi, MD
tions correctly, and this was associated with a 3.5-fold decrease
in SC use (aOR, 0.29; 95% CI, 0.19-0.44). Attitudes toward
Objectives: Parathyroidectomies are routinely performed as
use reflected prescribing practices and were linked to levels of
outpatient procedures, although some may require inpatient
knowledge, as respondents with less knowledge were more
stay. However, inpatient stay has also been linked to greater
likely to have a favorable outlook toward use.
complication rates in various procedures. The purpose of this
Conclusions: The use of SC for treatment of acute upper
study was to analyze differences in 30-day postoperative comrespiratory tract infection (URTI) is associated with clinician
plication rates for patients undergoing inpatient vs outpatient
demographics and clinical knowledge of SC. Otolaryng-
parathyroidectomies.
ologists are more likely to use SC for acute URTI in the
Methods: The American College of Surgeons National
Southeast United States and in private practice. Knowledge
Surgical Quality Improvement Program (ACS NSQIP) dataand provider education are key factors in prescribing
base was queried to identify patients who had undergone parapatterns.
thyroidectomies for primary hyperparathyroidism or benign
parathyroid neoplasms from 2005 to 2018. Randomized 1:1
Decrease in Opioid Prescriptions After
propensity score matching was implemented to control for difImplementation of Postoperative Guideline
ferences in patient demographics and preoperative comorbidiin a Large Tertiary Otolaryngology Practice
ties. The 2 cohorts were subsequently analyzed for differences
in 30-day postoperative complication rates.
Katherine Lees, MD (Presenter); Elizabeth
Results: The matched inpatient cohort (n = 3264) demonHabermann, PhD, MPH; Amy Glasgow, MHA;
strated significantly higher rates of pneumonia (P = .018),
Matthew L. Carlson, MD
unplanned intubation (P < .001), ventilator dependence
Objectives: Opioid overuse continues to be a public health
>48 hours (P = .001), urinary tract infections (P = .028), blood
concern
in the United States. Use of clinical practice guidelines
transfusions (P = .016), reoperation (P = .001), and readmisto
improve
opioid prescribing after surgery provides patients
sion (P < .001). Multivariate logistic regression analysis demwith
access
to
effective pain management rather than excessive
onstrated inpatient procedures to significantly increase the
prescriptions
that
can lead to dependence and overdose.
risk for unplanned reoperation (odds ratio [OR] 2.131, P =
Methods:
In
March
2018, the Department of Otolaryngology
.002) and readmission (OR 2.074, P < .001) in comparison
implemented
postoperative
opioid prescription guidelines at
with outpatient surgeries.
the
authors'
institution.
Opioid
prescriptions were converted
Conclusions: After controlling for preoperative variables,
to
oral
morphine
equivalents
(OME).
The preimplementation
inpatient parathyroidectomies were found to have increased
data
(October
2017-March
2018)
were
compared with postadverse events in comparison with patients undergoing outpaimplementation
data
(October
2018-March
2019) to evaluate
tient parathyroidectomies. Future studies are warranted to
for
changes
in
prescribing
practices
and
adherence
to recomunderstand the increased complications postoperatively.
mended guidelines.
Results: A total of 2407 index procedures were evaluated
Corticosteroid Use Among
(1306
pre- vs 1101 postimplementation). Overall, there was a
Otolaryngologists for the Treatment of
50%
reduction
in median OME for all procedures (75 pre- vs
Acute Upper Respiratory Infections
37.5 postimplementation; P < .001). When evaluating the 10
Sean M. Parsel, MD (Presenter); Edward D. McCoul, MD
individual procedure types, a statistically significant decrease
in prescribed OME was observed for direct laryngoscopy, sepObjectives: (1) Analyze the use of corticosteroids among
toplasty, tympanoplasty, mastoidectomy, thyroidectomy, parototolaryngology providers in treatment of upper respiratory
idectomy, and neck dissection (all, P < .001); tonsillectomy
infections. (2) Understand factors associated with unfounded
also decreased (P = .031), whereas declines in sinus surgery (P
use of systemic corticosteroids (SCs). (3) Examine the prac= .203) and transoral robotic surgery (P = .055) did not reach
tice variations associated with corticosteroid use in acute
significance. Despite a global reduction in opioids prescribed,
upper respiratory infections.
there was no statistical difference in opioid refills following
Methods: A cross-sectional evaluation of practicing otolarguideline implementation. Adherence to the opioid-prescribing
yngologists in the United States was performed through the
guideline was 75%.
use of a 16-question knowledge, attitude, and practice survey.
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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