The Utility of Comorbidity Indices in Assessing Head and Neck Surgery Outcomes: A Systematic Review.

Autor: Pai K; University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, U.S.A., Baaklini C; Northeast Ohio Medical University, Rootstown, Ohio, U.S.A., Cabrera CI; Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.; Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A., Tamaki A; Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.; Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A., Fowler N; Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.; Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A., Maronian N; Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, U.S.A.; Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2022 Jul; Vol. 132 (7), pp. 1388-1402. Date of Electronic Publication: 2021 Oct 18.
DOI: 10.1002/lary.29905
Abstrakt: Objective: To evaluate the utility of comorbidity index (CI) scores in predicting outcomes in head and neck surgery (HNS). The CIs evaluated were the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Kaplan-Feinstein Index (KFI), American Society of Anesthesiologists Physical Status (ASA-PS), Adult Comorbidity Evaluation-27 (ACE-27), National Cancer Institute Comorbidity Index (NCI-CI), and the Washington University Head and Neck Comorbidity Index (WUHNCI).
Methods: We report a systematic review according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases (PubMed, Cochrane, and Embase) and manual search of bibliographies identified manuscripts addressing how CI scores related to HNS outcomes.
Results: A total of 116 studies associated CI scores with HNS outcomes. CIs were represented in the literature as follows: ASA-PS (70/116), CCI (39/116), ACE-27 (24/116), KFI (7/116), NCI-CI (3/116), ECI (2/116), and WUHNCI (1/116). The most frequently cited justification for calculating each CI (if provided) was: CCI for its validation in other studies, ACE-27 for its utility in cancer patients, and ECI for its comprehensive design. In general, the CCI and ACE-27 were predictive of mortality in HNS. The ECI was most consistent in predicting >1-year mortality. The ACE-27 and KFI were most consistent in predicting medical complications.
Conclusion: Despite inconsistencies in the literature, CIs provide insights into the impact of comorbidities on outcomes in HNS. These scores should be employed as an adjunct in the preoperative assessment of HNS patients. Comparative studies are needed to identify indices that are most reliable in predicting HNS outcomes.
Level of Evidence: NA Laryngoscope, 132:1388-1402, 2022.
(© 2021 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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