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Associations Between Pre-, Post-, and Peri-operative Variables and Health Resource Use Following Surgery for Head and Neck Cancer

Overview
Journal Oral Oncol
Publisher Elsevier
Specialty Dentistry
Date 2019 Mar 9
PMID 30846167
Citations 3
Authors
Affiliations
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Abstract

Objective: We examined associations between pre-, post-, and peri-operative variables and health resource use in head and neck cancer patients.

Methods: 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.

Results: 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).

Conclusions: 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.

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FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer.

Hey C, Goeze A, Sader R, Zaretsky E Eur Arch Otorhinolaryngol. 2023; 280(5):2585-2592.

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Prolonged inpatient stay after upfront total laryngectomy is associated with overall survival.

Jacobs D, Kafle S, Earles J, Rahmati R, Mehra S, Judson B Laryngoscope Investig Otolaryngol. 2021; 6(1):94-102.

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