Association of Multiprofessional Preoperative Assessment and Information for Patients With Head and Neck Cancer With Postoperative Outcomes

Schmid, Martin J.; Giger, Roland; Nisa, Lluís; Mueller, Simon A.; Schubert, Maria; Schubert, Adrian D.

doi:10.1001/jamaoto.2021.4048

Cited by 10 publications

(10 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several groups have developed enhanced recovery after surgery (ERAS) pathways with targeted perioperative interventions to improve length of stay in HNSCC patients undergoing free flap reconstruction 53 . Intensive preoperative counseling has been shown to decrease the length of stay and reduce readmissions in high risk HNSCC patients 54–56 . Our data suggest that hypothyroid patients may benefit from programs to decrease the risk of readmission.…”

Section: Discussionmentioning

confidence: 78%

Hypothyroidism as an Independent Predictor of 30‐day Readmission in Head and Neck Cancer Patients

et al. 2023

View full text Add to dashboard Cite

ObjectivesTo define the role of hypothyroidism and other risk factors for unplanned readmissions after surgery for head and neck cancer.Study DesignRetrospective cohort study.MethodsThe Nationwide Readmission Database (NRD) was used to identify patients who underwent surgery for mucosal head and neck cancer (oral cavity, oropharynx, larynx, and hypopharynx) between 2010 and 2017. Univariate and multivariate logistic regression were performed to determine patient, tumor, and hospital related risk factors for 30‐day readmission. Readmitted patients were stratified by preoperative diagnosis of hypothyroidism to compare readmission characteristics.ResultsFor the 131,013 patients who met inclusion criteria, the readmission rate was 15.9%. Overall, 11.91% of patients had a preoperative diagnosis of hypothyroidism. After controlling for other variables, patients with a preoperative diagnosis of hypothyroidism had 12.2% higher odds of readmission compared to those without hypothyroidism (OR: 1.12, 1.03–1.22, p = 0.008). Patients with hypothyroidism had different reasons for readmission, including higher rates of wound dehiscence, fistula, infection, and electrolyte imbalance. Among readmitted patients, the length of stay for index admission (mean 10.5 days vs. 9.2 days, p < 0.001), readmission (mean 7.0 vs. 6.6 days, p = 0.05), and total hospital charge were higher for hypothyroid patients ($137,742 vs. $119,831, p < 0.001).ConclusionHypothyroidism is an independent risk factor for 30‐day readmission following head and neck cancer resection. Furthermore, hypothyroid patients are more likely to be readmitted for wound complications, infection, and electrolyte imbalance. Targeted interventions should be considered for hypothyroid patients to decrease readmission rates and associated patient morbidity, potentially leading to earlier initiation of adjuvant treatment.Level of Evidence3 Laryngoscope, 2023

show abstract

Section: Discussionmentioning

confidence: 78%

Hypothyroidism as an Independent Predictor of 30‐day Readmission in Head and Neck Cancer Patients

et al. 2023

View full text Add to dashboard Cite

show abstract

“…While there are clear psychological benefits to improving patient education, until recently, there were no publications in the HNC literature showing improved surgical outcomes from education intervention. Schmid et al recently found shorter LOS, reduced complications, and decreased cost after implementation of a preoperative multi‐professional assessment and information day (MUPAID) 42 . At this time, it is unknown which aspect of the MUPAID resulted in these improvements.…”

Section: Resultsmentioning

confidence: 99%

“…A small randomized trial by Longobardi et al showed that pre‐laryngectomy counseling by SLP increased patient satisfaction scores, decreased psychological distress, and facilitated greater use and acceptance of tracheoesophageal speech 49 . SLP counseling was included in the MUPAID protocol and may have played a contributory role in the improved outcomes 42 …”

Section: Resultsmentioning

confidence: 99%

Enhanced recovery after surgery, current, and future considerations in head and neck cancer

List,

Knackstedt,

Liu

et al. 2023

Laryngoscope Investig Oto

View full text Add to dashboard Cite

ObjectivesReview of the current and relevant literature to develop a list of evidence‐based recommendations that can be implemented in head and neck surgical practices. To provide rationale for the multiple aspects of comprehensive care for head and neck surgical patients. To improve postsurgical outcomes for head and neck surgical patients.MethodsExtensive review of the medical literature was performed and relevant studies in both the head and neck surgery and other surgical specialties were considered for inclusion.ResultsA total of 18 aspects of perioperative care were included in this review. The literature search included 276 publications considered to be the most relevant and up to date evidence. Each topic is concluded with recommendation grade and quality of evidence for the recommendation.ConclusionSince it's conception, enhanced recovery after surgery (ERAS) protocols have continued to push for comprehensive and evidence based postsurgical care to improve patient outcomes. Head and neck oncology is one of the newest fields to develop a protocol. Due to the complexity of this patient population and their postsurgical needs, a multidisciplinary approach is needed to facilitate recovery while minimizing complications. Current and future advances in head and neck cancer research will serve to strengthen and add new principles to a comprehensive ERAS protocol.Level of Evidence2a.

show abstract

“…Schmid et al explored the association of multiprofessional preoperative assessment and information with postoperative outcomes for patients with head and neck cancer. The magnitude of the differences in the distribution of characteristics at admission between patients in the intervention group and in the control group was compared using both standardized and nonstandardized effect sizes.…”

Section: Nonstandardized and Standardized Effect Sizesmentioning

confidence: 99%

A Simple Guide to Effect Size Measures

Kallogjeri

Piccirillo

2023

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

ImportanceEffect size quantifies the magnitude of the difference or the strength of the association between variables. In clinical research it is important to calculate and report the effect size and the confidence interval (CI) because it is needed for sample size calculation, meaningful interpretation of results, and meta-analyses.ObservationsThere are many different effect size measures that can be organized into 2 families or groups—d family and r family. The d family includes measures that quantify the differences between groups. The r family includes measures that quantify the strength of the association. Effect sizes that are presented in the same units as the characteristic being measured and compared are known as nonstandardized or simple effect sizes. The nonstandardized effect sizes have the advantage of being more informative, easier to interpret, and easier to evaluate in the light of clinical significance or practical relevance. Standardized effect sizes are unit-less and are helpful for combining and comparing effects of different outcome measures or across different studies (ie, meta-analysis).Conclusions and RelevanceThe choice of the correct effect size measure depends on the research question, study design, targeted audience, and the statistical assumptions being made. For a complete and meaningful interpretation of results from a clinical research study, the investigator should make clear the type of effect size being reported, its magnitude and direction, degree of uncertainty of the effect size estimate as presented by the CIs, and whether the results are compatible with a clinically meaningful effect.

show abstract

Association of Multiprofessional Preoperative Assessment and Information for Patients With Head and Neck Cancer With Postoperative Outcomes

Cited by 10 publications

References 53 publications

Hypothyroidism as an Independent Predictor of 30‐day Readmission in Head and Neck Cancer Patients

Hypothyroidism as an Independent Predictor of 30‐day Readmission in Head and Neck Cancer Patients

Enhanced recovery after surgery, current, and future considerations in head and neck cancer

A Simple Guide to Effect Size Measures

Contact Info

Product

Resources

About