PGY-2 Resident Loma Linda University Loma Linda University Loma Linda , California
Objective: To assess the impact of vocal fold augmentation on pneumonia rates, hospitalization, and mortality.
Method: We queried a national database of insurance claims for Current Procedural Terminology (CPT) codes 31571, 31591, and 31574, representing vocal fold augmentation performed between January 1, 2017 - December 31, 2018. Adult patients who underwent the relevant procedures were included. Patients who underwent concurrent excisional procedure, indicated by CPT code 31541, were excluded. Patients were assessed for incidences of pneumonia 6 months prior to vocal fold augmentation as well as 6 months following augmentation. Hospitalization and death in the months following the procedure were also recorded. Demographic information and comorbidities were collected for all patients included.
Results: We identified 68,063 adult patients who underwent vocal fold augmentation. After excluding patients who underwent a laryngeal excision at the time of augmentation, 15,808 vocal fold augmentations were identified in 15,757 patients, with 51 patients undergoing multiple procedures during the study period. The average age was 62.9 years. 58.1% of patients were females and 41.9% were male. Pre and post-procedure pneumonia rates were assessed using the McNemar’s Chi-Square Test. During the 6 month pre-procedure period, 10.1% of patients developed pneumonia. During the 6 month post-procedure period, the pneumonia rate dropped to 7.5% (p <.0001). A number of patient factors and comorbidities including male sex, tobacco use, and, and vocal fold paralysis were associated with increased risk of postoperative pneumonia.
Conclusion: Evidence from a national insurance claim database demonstrates decreased rates of pneumonia in patients following vocal fold augmentation.