Factors associated with complications in total laryngectomy without microvascular reconstruction

Background: There is little population-level data evaluating risk factors for postoperative complications after total laryngectomy. Methods: We conducted a retrospective review of the American College of Surgeons National Quality Improvement Program identifying patients who underwent total laryngectomy as a primary procedure from 2005 to 2014. Multivariate analysis was performed to identify variables that were independently associated with overall and major complications. Results: Eight hundred seventy-one cases met inclusion criteria. Three hundred twenty-eight patients (37.7%) had complications, with operative time (hours; P <.0001), class III (P <.001) wound status, and patient age (decade; P =.003) associated with overall complications. Two hundred one patients had major complications that were associated with steroid use (P =.01) and class III (P =.0083) wound classification. Preoperative hematocrit was correlated with a reduction of all and major complications on multivariate analysis (P <.0001 and P =.036). Conclusion: Identifying and optimizing risk factors may improve outcomes in total laryngectomy.