Hatch Jonathan L, Boersma Isabel M, Weir Forest W, Bauschard Michael J, Holcomb Meredith A, Lambert Paul R, Meyer Ted A
Department of Otorhinolaryngology Head and Neck Surgery, Medical University of South Carolina, SC 29425, USA.
World J Otorhinolaryngol Head Neck Surg. 2018 Jan 19;3(4):231-234. doi: 10.1016/j.wjorl.2017.12.004. eCollection 2017 Dec.
The rising incidence of obesity in the United States is associated with increased healthcare expenditures and resource allocation. Obesity has been associated with prolonged operating times during surgical procedures. The primary objective of this study is to compare body mass index (BMI) to length of surgery during cochlear implantation.
A retrospective case control study from a tertiary academic referral center was performed. Patients included were adults who underwent primary, single-sided cochlear implantation with documented BMI and operating room (OR) times from January 2009 to July 2015. The following data were collected: BMI, total operating room time (TORT), surgical operating room time (SORT), ASA status, perioperative and postoperative complications, age, and gender.
Two hundreds and thirty-four patients were included and stratified into obese (BMI >30) and non-obese (BMI < 30) categories. Statistical analysis was performed comparing TORT against the obesity category along with other variables. Independent sample -test demonstrated that obesity increases TORT and SORT by 16.8 min ( = 0.0002) and 9.3 min ( = 0.03), respectively, compared to the non-obese group. Multivariate linear regression analysis demonstrated no statistically significant impact of gender, or ASA status on total operating or surgical time. Obesity was associated with increased perioperative complications (odds ratio [], 6.21; 95% , 1.18-32.80; = 0.03) and postoperative complications (, 3.97; 95% , 1.29-12.26; = 0.02).
Obesity leads to longer TORT and SORT during primary cochlear implant surgery. Obesity is also associated with increased perioperative and postoperative complications compared to non-obese patients. These data have implications with utilization of operating room resources.
美国肥胖发病率的上升与医疗保健支出和资源分配的增加有关。肥胖与手术过程中手术时间延长有关。本研究的主要目的是比较人工耳蜗植入手术期间体重指数（BMI）与手术时长的关系。
在一家三级学术转诊中心进行了一项回顾性病例对照研究。纳入的患者为2009年1月至2015年7月期间接受初次单侧人工耳蜗植入手术且记录有BMI和手术室（OR）时间的成年人。收集了以下数据：BMI、总手术室时间（TORT）、手术操作室时间（SORT）、美国麻醉医师协会（ASA）分级、围手术期和术后并发症、年龄和性别。
共纳入234例患者，并分为肥胖组（BMI>30）和非肥胖组（BMI<30）。对TORT与肥胖类别以及其他变量进行了统计分析。独立样本t检验表明，与非肥胖组相比，肥胖使TORT和SORT分别增加了16.8分钟（P = 0.0002）和9.3分钟（P = 0.03）。多因素线性回归分析表明，性别或ASA分级对总手术时间或手术时间没有统计学上的显著影响。肥胖与围手术期并发症增加相关（优势比[OR]，6.21；95%置信区间[CI]，1.18 - 32.80；P = 0.03）和术后并发症增加相关（OR，3.97；95%CI，1.29 - 12.26；P = 0.02）。
肥胖导致初次人工耳蜗植入手术期间TORT和SORT延长。与非肥胖患者相比，肥胖还与围手术期和术后并发症增加相关。这些数据对手术室资源的利用具有启示意义。
