Evaluation of the head and neck cancer patient population and the incidence of hospitalization at an academic medical center

Abstract

Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. The primary objective was to characterize the head and neck cancer population at an academic medical center. Secondary objectives included describing the clinical and social factors associated with hospitalization. Results There were 109 patients with head and neck cancer included in the analysis. Of these patients, 38 (35%) were hospitalized. The factors that were significantly associated with hospitalization on univariable logistic regression were former alcohol abuse, being on a nonstandard of care chemotherapy regimen, and having a chemotherapy agent discontinued. On multivariable logistic regression, the factor that was significantly associated with hospitalization was having a chemotherapy agent discontinued. The most common reasons for hospitalization included shortness of breath/respiratory failure, fever/neutropenic fever, and infection. The most common new supportive care medications prescribed at discharge were stool softeners or laxatives and opioids. Conclusion This study identified several factors which may be useful to identify patients as high risk for hospitalization and the next steps will be to determine and study the role of the pharmacist in preventing hospitalization of these patients. Further studies are needed to assess the impact of adding a pharmacist to the head and neck cancer multidisciplinary team.

Factors Predictive of Postoperative Acute Respiratory Failure Following Inpatient Sinus Surgery

“…Alcohol dependence and abuse has been shown to be an independent risk factor of poor outcomes in head and neck cancer surgery patients. 25 In their evaluation of adult patients following oral and maxillofacial surgery, Loeffelbein et al 26 found that alcohol abuse was an independent risk factor of postoperative pulmonary complications. Alcohol dependence and abuse is associated with liver disease, and such liver pathology may increase in the risk of poor postoperative outcomes.…”

A Novel Framework for Drug Synergy Prediction using Differential Evolution based Multinomial Random Forest

“…[34]. The examination by Hazelden et al, 2019, identified a few factors which might be helpful to recognize patients as high risk for hospitalization and the following stages will be to decide and consider the role of the drug specialist in preventing hospitalization of these patients [35]. However, machine learning based drug synergy prediction approaches suffer from the parameter tuning problem.…”

Evaluation of pharmacist interventions in a head and neck medical oncology clinic

“…2 Since the majority of patients often present with locally advanced disease, multi-modality treatment is typically required and may include surgery, radiation, and/or systemic therapy. 1,4,5 As a result, HNC treatment is associated with significant toxicities, such as severe mucositis, odynophagia, dysphagia, dehydration, emesis, and poor oral intake. 4,5 It is well established that these toxicities can become severe enough to warrant hospitalization.…”

“…1,4,5 As a result, HNC treatment is associated with significant toxicities, such as severe mucositis, odynophagia, dysphagia, dehydration, emesis, and poor oral intake. 4,5 It is well established that these toxicities can become severe enough to warrant hospitalization. 4,5 Therefore, HNC treatment necessitates a multidisciplinary approach to ensure timely and coordinated care throughout treatment.…”

“…4,5 It is well established that these toxicities can become severe enough to warrant hospitalization. 4,5 Therefore, HNC treatment necessitates a multidisciplinary approach to ensure timely and coordinated care throughout treatment. 1,3 The literature has described that early palliative care interventions in patients with advanced cancer can improve quality of life, prolong survival, and decrease social distress.…”