Readmission following primary surgery for larynx and oropharynx cancer in the elderly

Abstract

2c. Laryngoscope, 127:631-641, 2017.

Thirty‐day readmission in patients undergoing head and neck microvascular reconstruction

“…This is in accordance with previously published descriptions of 30‐day readmissions in head and neck cancer patients and patients undergoing head and neck microvascular reconstruction . The economic impact of unplanned readmissions in patients with head and neck cancer has been described, as the median cost of a readmission can range from $15,000‐$21,000 . Unplanned readmissions also result in significant additional morbidity for the patient, as one‐third of readmissions involve a surgical procedure.…”

“…This is similar to the findings of Offodile et al, who also found that nonoral cavity aerodigestive tract subsites were associated with an increased risk of readmission. Other series analyzing unplanned readmissions in patients with pharyngeal or laryngeal cancer have also found high rates of unplanned readmission, ranging from 13.9%‐29.6% . These patients may be at higher risk of readmission relative to patients receiving free flaps for oral cavity reconstruction because of a higher rate of prior (chemo)radiation, predisposing them to delayed wound healing complications that manifest after discharge, resulting in readmission.…”

“…Unplanned hospital readmission after surgery for head and neck cancer is common . Negative consequences of 30‐day unplanned readmission after head and neck cancer surgery include increased cost of care, delay in initiating timely adjuvant therapy, and increased mortality . Therefore, the 30‐day unplanned readmission rate is used as 1 measure of quality head and neck cancer care delivery …”

Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective

“…Patients with oropharyngeal cancer were more likely to present with a secondary diagnosis of lymph node involvement ( P < 0.0001), indicating either late stage of presentation or new disease progression. Prior research has also demonstrated that patients undergoing surgery for oropharyngeal cancer face higher rates of postoperative complications and hospital admission as compared to other anatomic subsites . This high rate of iatrogenic complications is particularly important within the context of the HPV epidemic.…”

Two‐year prevalence of dysphagia and related outcomes in head and neck cancer survivors: An updated SEER‐Medicare analysis

“…Population‐level data are critical to examine broad outcomes outside academic institutions. Prior population‐level analyses from the United States often use Surveillance, Epidemiology, and End Results (SEER)‐Medicare; these include analyses of feeding tube duration as a function of radiotherapy modality, case‐control comparisons of aspiration pneumonia risk after chemoradiation (CRT), examination of dysphagia as a predictor of morbidity, as well as quality studies suggesting positive impact of early speech pathology utilization …”