Outcomes and Predictors of Morbidity after Carotid Body Tumor Resection.

BACKGROUND: Carotid body tumors (CBT) are uncommon neuroendocrine tumors at the carotid bifurcation treated with resection. The goal of this study was to examine patient outcomes after CBT resection and establish predictors of morbidity.

METHODS: Patients undergoing CBT resection were identified from the NSQIP database over eleven years. Demographics, past medical history, pre-operative labs, procedural details, morbidity and mortality were recorded. Multivariable logistic regression (MLR) analysis was performed to determine independent predictors of morbidity.

RESULTS: From 2010-2020, 668 CBT resections were identified. The majority of patients were female (65%) and white (72%) with a mean age of 56 (SD+/-16). Average BMI was 29.9 (SD+/-7.1). Arterial resection occurred in 81 patients (12%). 6% of patients experienced morbidity, most commonly re-operation (2.4%). Morbidity was more common in patients with higher BMI (33.1 vs. 29.7, p=0.005), COPD (10% vs. 1.9%, p=0.012), higher ASA (p=0.005), and lower albumin (3.7 vs. 4, p=0.016). Morbidity was not increased with arterial resection (p=1) or based on length of operation (p=0.169). Morbidity did not impact mortality (p=0.06) though led to longer LOS (8 days vs. 2.4, p<0.001). On MLR, pre-operative BMI was the only risk factor for morbidity (OR 1.06, 95%CI 1.02-1.1, p=0.005).

CONCLUSIONS: CBT resection is very well tolerated with low stroke rates, morbidity, and mortality. Arterial resection leads to increased transfusion requirements and LOS but did not increase stroke rates, mortality, or overall morbidity. Within the NSQIP database, pre-operative BMI was the only predictor of post-operative morbidity, which lead to significantly longer LOS.