Cognitive Function and Postoperative Outcomes in Patients with Head and Neck Cancer.

Autor: Larrabee K; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA., Meeks N; School of Medicine, Wayne State University, Detroit, Michigan, USA., Williams AM; Department of Family Medicine, Henry Ford Health, Detroit, Michigan, USA., Springer K; Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA., Siddiqui F; Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan, USA., Chang SS; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA., Ghanem T; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA., Wu VF; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA., Momin S; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA., Tam S; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2023 Nov; Vol. 133 (11), pp. 2999-3005. Date of Electronic Publication: 2023 Apr 05.
DOI: 10.1002/lary.30677
Abstrakt: Objective: Determine the relationship between cognitive function and postoperative outcomes.
Methods: This IRB-approved retrospective cohort study included all patients treated between August 2015 and March 2020 undergoing major surgery for aerodigestive cancer or cutaneous/thyroid cancer that required free-flap reconstruction at Henry Ford Hospital. Routine administration of the Montreal Cognitive Assessment (MoCA) was completed as part of preoperative psychosocial evaluation. Outcomes included postoperative diagnosis of delirium, discharge disposition, return to the emergency department within 30 days of surgery, and readmission within 30 days of surgery. Univariate and multivariate logistic regression were used to determine the associations between preoperative MoCA score and each outcome measure.
Results: One hundred thirty-five patients with HNC were included in the study (mean [SD] age, 60.7 [±10.8] years; 70.4% [n = 95] male; 83.0% [n = 112] White, 16.3% [n = 22] Black). The average preoperative MoCA score was 23.4 (SD ± 4.5). Based on the MoCA score, 35% (n = 47) scored ≥26 (i.e., normal cognitive status), 55.6% (n = 75) scored between 18 and 25 (i.e., mild impairment), 8.1% (n = 11) scored between 10 and 17 (i.e., moderate impairment), and 1.5% (n = 2) scored <10 (i.e., severe impairment). After adjusting for other variables, a lower MoCA score was associated with discharge disposition to a location other than home and prolonged length of hospital stay.
Conclusions: Preoperative cognitive function in patients undergoing major head and neck surgery for head and neck cancer was associated with discharge destination and length of stay.
Level of Evidence: 3 Laryngoscope, 133:2999-3005, 2023.
(© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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