Objective Few studies have examined operative occasions for cochlear implantation (CI)

Objective Few studies have examined operative occasions for cochlear implantation (CI) using multivariable linear regression analyses to identify predictors of case length. fellow) American Society of Anesthesiologists (ASA) physical classification age gender and surgeon identity. Results We identified a total of 455 unilateral CI procedures (n = 35 pediatric n = 420 adult). Mean total OR time was 193.6 min (SD = 58.9 min) and mean procedural time was 147.1 min (SD = 56.2). The presence of trainees was associated with a significant difference in procedure time (149.9 min [SD = 54.9] with trainees vs. 136.6 min [SD= 59.9] without p=0.0375). Trainee involvement did not significantly increase total OR time (196.3 minutes [SD=56.9] with residents 183.8 minutes [SD=65.0] without p=0.0653). Surgeon BS-181 HCl identity was also associated with differences in procedural time (p<0.001). Patient age gender ASA classification pediatric designation had no significant impact on length of case. Conclusions Major predictors of longer procedural OR occasions for CI are surgeon identity and trainee participation. Few published data exist on length of cochlear implantation in an academic setting using multivariable linear regression analyses. Our data may be instructive for comparative analyses and has implications for operative planning and surgical education. Keywords: cochlear implantation operative occasions otolaryngology education Introduction Healthcare spending in the United States is expected to increase by 6.2% over the BS-181 HCl next 10 years and projected to be 20% of the gross domestic product by 2022.1 Operating room (OR) time has been estimated to cost between $5-42 per minute depending on the location and specialty.2-6 Identifying sources of inefficiency in the OR has been the subject of substantial interest and study both in the business and biomedical literature.7-13 Multiple studies in the otolaryngology5 and non-otolaryngology2-4 6 14 15 literature have focused on the inefficiencies associated with surgical education in the OR. Few studies however have Rabbit polyclonal to ZNF787.ZNF787 may be involved in transcriptional regulation. examined the impact of trainees around the duration of cochlear implantation a procedure necessitating meticulous operative technique and the use of expensive neuroprosthetic devices.16 17 An accurate estimate of duration of BS-181 HCl cochlear implant surgery and discrete analysis of which factors may increase operative occasions is valuable for operative planning cost-benefit analysis and reimbursement fees. Shorter surgical occasions translate into decreased duration of general anesthesia and potentially decreased cost. Indeed as implant technology improves and the indications increase for implantation making it more applicable for new patient groups it is important to have standardized data on operative characteristics of the procedure. While prior studies have examined OR time for cochlear implantation in an academic setting these studies are limited in scope as they occurred in discrete patient populations such as older patients18 different hospital locations16 and were not primarily designed BS-181 HCl to assess the impact of trainee participation on OR occasions.17 Furthermore prior studies largely used univariable models for statistical analysis limiting their ability to account for perioperative confounders. To address whether surgical trainee participation in CIs results in differential total or procedural operative occasions we retrospectively assessed total OR and procedural occasions for isolated unilateral implants over a five-year period BS-181 HCl (2009-2013) in children and adults. We developed a multivariable linear regression model using additional perioperative predictors beyond trainee participation to exclude potential confounders. Our investigation builds upon previous studies on perioperative factors of CI and offers a more strong model to delineate the impact of trainees on operative occasions. BS-181 HCl Methods This study was granted institutional review board approval by the Massachusetts Vision and Ear Infirmary (MEEI) Human Studies Committee. The MEEI operating room log was reviewed to identify cases of isolated unilateral cochlear implantation between January 2009 and December 2013. All procedures included were supervised or performed by one of 14 academic surgeons including academic otologist/neurotologists and pediatric otolaryngologists. All cases were performed at the MEEI main hospital. Cases were grouped according to the.