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International Journal of Otolaryngology
Volume 2016, Article ID 8107892, 8 pages
http://dx.doi.org/10.1155/2016/8107892
Research Article

Critical Care Admissions following Total Laryngectomy: Is It Time to Change Our Practice?

1Department of Otorhinolaryngology, Royal Glamorgan Hospital, Llantrisant CF72 8XR, UK
2Department of Anaesthesia and Critical Care, Royal Glamorgan Hospital, Llantrisant CF72 8XR, UK

Received 1 March 2016; Revised 18 July 2016; Accepted 7 August 2016

Academic Editor: Cherie-Ann Olympia Nathan

Copyright © 2016 Hussein Walijee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Critical Care Unit (CCU) beds are a limited resource and in increasing demand. Studies have shown that complex head and neck patients can be safely managed on a ward setting given the appropriate staffing and support. This retrospective case series aims to quantify the CCU care received by patients following total laryngectomy (TL) at a District General Hospital (DGH) and compare patient outcomes in an attempt to inform current practice. Data relating to TL were collected over a 5-year period from 1st January 2010 to 31st December 2015. A total of 22 patients were included. All patients were admitted to CCU postoperatively for an average length of stay of 25.5 hours. 95% of these patients were admitted to CCU for the purpose of close monitoring only, not requiring any active treatment prior to discharge to the ward. 73% of total complications were encountered after the first 24 hours postoperatively at which point patients had been stepped down to ward care. Avoiding the use of CCU beds and instead providing the appropriate level of care on the ward would result in a potential cost saving of approximately £8,000 with no influence on patient morbidity and mortality.