Prediction of mortality and morbidity in head and neck cancer patients 80 years of age and older undergoing surgery
| Autor: | Jay F. Piccirillo, Heidi E. L'Esperance, Dorina Kallogjeri, Jason T. Rich, Shahnawaz Yousaf |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry Mortality rate Head and neck cancer Retrospective cohort study medicine.disease Comorbidity Dysphagia Surgery 03 medical and health sciences 0302 clinical medicine Otorhinolaryngology 030220 oncology & carcinogenesis medicine medicine.symptom 030223 otorhinolaryngology business Complication Risk assessment Survival rate |
| Zdroj: | The Laryngoscope. 128:871-877 |
| ISSN: | 0023-852X |
| Popis: | Objectives To determine postoperative complications and mortality rates in octogenarian and older head and neck cancer patients undergoing ablative surgical resections and to identify factors associated with postoperative morbidity and mortality. Methods Retrospective cohort study investigating risk factors for 30-day serious complication risk and 90-day mortality risk for patients aged 80 years and older who underwent ablative head and neck oncologic surgical procedures at an academic tertiary care center between 2005 and 2015. Results Of the 219 patients who underwent 241 surgeries, 74 patients experienced serious complications within 30 days and 25 died within 90 days of surgery. American Society of Anesthesiologists (ASA) score of 4 or greater, and operating room (OR) time ≥6 hours were independently associated with serious complications, whereas age ≥90 years, overall severe comorbidity score, presence of preoperative dysphagia, and large extent of resection were associated with increased risk of death in 90 days. Models to predict risk of 30-day serious complications and 90-day mortality were then developed. Conclusion Patient and surgical treatment factors predict risk of serious complications and mortality in patients aged 80 years and older undergoing ablative head and neck surgery. Predictive models may guide preoperative discussion with patients. Level of Evidence 2b. Laryngoscope, 2017 |
| Databáze: | OpenAIRE |
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