2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook

Fig. 1. Flow diagram of patient selection. CPT 5 Current Procedure Terminol- ogy; I&D 5 incision and drainage; NSQIPP 5 National Surgical Quality Improvement Program Pediatric.

drainage, with a rate of 11.5% for those treated on day 0, 17.3% for days 1 to 2, and 25.0% for days 3 to 7 ( P 5 0.02) (Fig. 3). The rate of specific complications is shown in Table II. Occurrence of postoperative septic shock was significantly more likely in those in whom drainage was delayed ( P 5 0.02), as was the rate of unplanned intuba- tion or prolonged ventilation ( P 5 0.01). A prolonged length of stay ( 7 days) was also significantly more likely in patients with delayed drainage.

Adult patients in whom operative drainage was delayed were more likely to have DM, use steroids for a chronic con- dition, have more advanced ASA class, and meet sepsis cri- teria. Pediatric patients in whom operative drainage was delayed were more likely to be white and have advanced ASA class. Patients with an elevated leukocytosis were more likely to undergo early drainage in both populations. In adult patients, there was a significant increase in abscess-specific M&M with delay in incision and

Fig. 2. Frequency of cases based on day from admission to surgery.

Laryngoscope 126: August 2016

Cramer et al.: Delay in Drainage of Deep Neck Abscess

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