Clinical and Financial Outcomes Associated with Vocal Fold Paralysis in Congenital Cardiac Surgery

Abstract Objectives Vocal fold paralysis (VFP) has been shown to increase resource utilization in several surgical fields. However, its burden in congenital cardiac surgery, a specialty known to be associated with high resource use, has not yet been examined. We aimed to assess the impact of VFP on costs, lengths of stay and readmissions following congenital cardiac surgery. Design A retrospective analysis of administrative data. Setting The 2010-2017 National Readmissions Database. Participants All pediatric patients undergoing congenital cardiac operations. Interventions None. Measurements and Main Results Vocal fold paralysis was defined using International Classification of Disease 9th-10th Revision diagnosis codes. The primary outcome of interest was 30-day non-elective readmissions, while 90-day readmissions, costs, length of stay and discharge status were also considered. Of an estimated 124,486 patients meeting study criteria, 2,868 (2.3%) were identified with VFP. Incidence of VFP increased over the study period (0.7% in 2010 to 3.2% in 2017, nptrend Conclusions Readmission rates after congenital cardiac surgery are significantly greater among those with VFP, as are costs, lengths of stay and non-home discharges. Therefore, further efforts are necessary to increase awareness and reduce the incidence of VFP in this vulnerable population and minimize the financial burden of congenital cardiac surgery on the US medical system.