Associations between pre-, post-, and peri-operative variables and health resource use following surgery for head and neck cancer.

Adult Aged Aged, 80 and over Deglutition Disorders / complications Emergency Service, Hospital Female Head and Neck Neoplasms / complications Health Resources Humans Length of Stay Male Middle Aged Patient Readmission Patient Reported Outcome Measures Postoperative Period Preoperative Period Quality of Life Retrospective Studies
Head and neck cancer Health resource use M D Anderson Dysphagia Inventory Quality of life Surgery

Journal

Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118

Informations de publication

Date de publication:
03 2019
Historique:
received: 27 09 2018
revised: 31 01 2019
accepted: 04 02 2019
entrez: 9 3 2019
pubmed: 9 3 2019
medline: 9 4 2020
Statut: ppublish

Résumé

We examined associations between pre-, post-, and peri-operative variables and health resource use in head and neck cancer patients. Patients (N = 183) who were seen for a pre-surgical consult between January 2012 and December 2014 completed surveys that assessed medical history, a patient-reported outcome measure (PROM) of dysphagia, and quality of life (QOL). After surgery, peri-operative (e.g., tracheostomy, feeding tube) and post-operative (e.g., complications) variables were abstracted from patients' medical records. Multivariate regression models using backward elimination showed that pre-surgical University of Washington Quality of Life (UW-QOL) Inventory and M.D. Anderson Dysphagia Inventory (MDADI) composite scores, documented surgical complications, and having a tracheostomy, were all significant predictors of hospital length of stay, explaining 57% of the total variance (F(5, 160) = 18.71, p < .001). Male gender, psychiatric history, and lower pre-surgical MDADI scores significantly predicted thirty-day unplanned readmissions (30dUR). Pre-surgical MDADI composite scores also significantly predicted emergencey department (ED) visits within 30 days of initial hospital discharge (p = .02). Assessment of PROMs and QOL in the pre-surgical setting may assist providers in identifying patients at risk for prolonged LOS and increased health resource use after hospital discharge.

Identifiants

DOI: 10.1016/j.oraloncology.2019.02.004 PMID: 30846167 PMC: PMC6410733
pubmed: 30846167
pii: S1368-8375(19)30039-9
doi: 10.1016/j.oraloncology.2019.02.004
pmc: PMC6410733
mid: NIHMS1521385
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

102-108

Subventions

Organisme : NCI NIH HHS
ID : R21 CA178478
Pays : United States

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

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Auteurs

Hoda Badr (H)

Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA. Electronic address: hoda.badr@bcm.edu.

Maximiliano Sobrero (M)

Department of Emergency Medicine, Alameda Health System, Oakland, CA, USA.

Joshua Chen (J)

Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA; Department of Psychology, University of St Thomas, Houston, TX, USA.

Tamar Kotz (T)

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Eric Genden (E)

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Andrew G Sikora (AG)

Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.

Brett Miles (B)

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

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