Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back
Rate ePoster

Head and Neck Surgery

(054) Asymptomatic Preoperative Leukocytosis and Salivary Gland Excision Clinical Outcomes

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • SA

    Sugosh M. Anur, BS

    Medical Student
    Rowan University School of Osteopathic Medicine
    Morris Plains, New Jersey, United States

    • Co-Author(s)

  • Rushi Patel, BA

    Medical Student
    Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School
    Newark, New Jersey, USA

  • DS

    Dhvani R. Shihora, BS

    Medical Student
    Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School
    Rutherford, New Jersey, United States

  • PP

    Prayag Patel, MD

    Fellow
    Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, USA

    • Senior Author(s)

  • Jean Anderson Eloy, MD, FACS, FACS

    Distinguished Professor and Vice Chair of Otolaryngology - Head and Neck Surgery
    Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School
    West Orange, New Jersey, United States

Disclosure(s):
Sugosh M. Anur, BS: No relevant relationships to disclose.
Dhvani R. Shihora, BS: No relevant relationships to disclose.


Introduction: An increase in white blood cell (WBC) count can indicate the presence of infection, inflammation, or immune disorder. Some patients may have elevated WBC counts without any symptoms. The objective of this study is to determine association between asymptomatic leukocytosis with postoperative outcomes following salivary gland excision (SGE).

Methods: The 2005-2018 National Surgical Quality Improvement Program database was queried for all patients undergoing SGE. Patients with preoperative sepsis, septic shock, pneumonia, wound infection, disseminated cancer, renal failure, and history of chronic steroid use were excluded. Cases were grouped into leukocytosis (> 11k/µL) or normal WBC ( < 11k/µL). Univariate and multivariable analyses were performed.

Results: A total of 18,416 patients underwent salivary gland excision, of which 12,553 patients had valid preoperative WBC values. 664 patients (5.29%) had preoperative leukocytosis. Adjusting for confounding variables, multivariable regression analyses showed association between leukocytosis and all postoperative complications (OR: 2.084 (1.604-2.707), p< 0.01). Specifically, leukocytosis was significantly associated with superficial surgical site infection (OR: 2.304 (1.523-3.485), p< 0.001), pneumonia (OR: 3.552 (1.863-6.775), p< 0.01), bleeding transfusion (OR: 2.432 (1.580-3.741), p< 0.01), and DVT requiring therapy (OR: 6.269 (1.734-22.665), p=0.005).

Conclusions: Our study demonstrates that patients with preoperative asymptomatic leukocytosis undergoing salivary gland resection are at risk of experiencing postoperative complications. Surgical site infection, pneumonia, bleeding transfusion, and DVT development were associated with increased white blood cell count. Elevated WBC count in asymptomatic patients could indicate need for increased monitoring to minimize adverse postoperative outcomes.