Morbidity and mortality associated with ventral skull base surgery: analysis of the National Surgical Quality Improvement Program

Roshansa Singh, Sana H. Siddiqui, Yonghee Choi, Monica C. Azmy, Nirali M. Patel, Jordon G. Grube, Wayne D. Hsueh, Soly Baredes, Jean Anderson Eloy

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Ventral skull base (VSB) surgery has associated morbidity and mortality that is poorly defined. In this study we aim to identify factors associated with adverse events in VSB surgery. Methods: We queried the database of the American College of Surgeons National Surgical Quality Improvement Program for cases of VSB surgery during the period 2005-2014. Patients with complications, readmissions, reoperations, or mortality were compared to those without adverse events. Results: Nine hundred patients were included; 253 (28.1%) had complications, underwent reoperation, were readmitted, or died. These patients were older (42.6% vs 32.8, p = 0.032) and had higher rates of congestive heart failure (CHF) (3.2% vs 0.2%, p < 0.0001), disseminated cancer (8.3% vs 4.6%, p = 0.032), and preoperative sepsis (8.7% vs 2.2%, p < 0.0001). Other comorbidities included long-term steroid use (13.4% vs 9.0%, p = 0.046) and higher rates of preoperative transfusion (2.4% vs 0%, p < 0.0001). The most common complication was bleeding (13.7%). Preoperative systemic sepsis (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.0-6.6) and lower hematocrit (OR, 2.1; 95% CI, 1.4-3.4) were more likely to be associated with a complication. Those with disseminated cancer (OR, 12.0; 95% CI, 2.9-50.5) were more likely to experience 30-day mortality. Black patients had lower rates of reoperation (OR, 0.3; 95% CI, 0.1-0.8), whereas patients with CHF (OR, 12.6; 95% CI, 1.7-94.4) and hypertension (OR, 2.1; 95% CI, 1.1-4.0) had higher rates of reoperation. Predictors of extended length of stay were Hispanic ethnicity (OR, 2.2; 95% CI, 1.2-4.1) and lower hematocrit (OR, 2.3; 95% CI, 1.5-3.6). Conclusion: VSB surgery can involve significant morbidity and mortality, and thus identifying risk factors allows for better prognostication and delivery of care in these patients.

Original languageEnglish (US)
Pages (from-to)1485-1491
Number of pages7
JournalInternational Forum of Allergy and Rhinology
Issue number12
StatePublished - Dec 1 2019

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Otorhinolaryngology


  • National Surgical Quality Improvement Program
  • morbidity
  • mortality
  • rhinologic surgery
  • skull base surgery
  • ventral skull base surgery


Dive into the research topics of 'Morbidity and mortality associated with ventral skull base surgery: analysis of the National Surgical Quality Improvement Program'. Together they form a unique fingerprint.

Cite this