TY - JOUR
T1 - Presentation and Outcomes of Elderly Patients Undergoing Head and Neck Surgeries
T2 - A National Perspective
AU - Al-Qurayshi, Zaid
AU - Sullivan, Christopher Blake
AU - Schwalje, Adam
AU - Walsh, Jarrett
AU - Bayon, Rodrigo
AU - Tufano, Ralph
AU - Kandil, Emad
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2020.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Objectives: To examine clinical profile and outcomes of elderly patients (65-90 years) undergoing head and neck surgeries in the United States. Study Design: A retrospective cross-sectional analysis. Setting: The Nationwide Readmissions Database, 2010 to 2015. Subjects and Methods: Adult (≥18 years) patients who underwent head and neck surgeries. Analysis included χ2 test and logistic analysis. Results: A total of 113,602 and 32,580 patients <65 and ≥65 years old, respectively, were included. Patients ≥65 years old were more likely to have multiple comorbidities (62.8% vs 32.6%, P <.001) and to present with head and neck cancer (19.8% vs 11.4%, P <.001). The most common comorbidity was diabetes (21.0%). The most common cancer types by site were mouth (29.12%), thyroid (28.08%), and nonmelanoma skin cancer (13.22%). The percentage of geriatric patients who underwent head and neck surgeries increased from 21.8% in 2010 to 25.0% in 2015 (P <.001). A total of 5450 (16.85%) patients developed postoperative complications, and the most common complications were pulmonary related (10.55%), bleeding (6.96%), acute renal failure (6.01%), and infection (3.97%). Blood transfusion was required in 3.53% of the patients. Readmission prevalence was 0.32%, and mortality risk was twice as likely (odds ratio, 2.05; 95% confidence interval, 1.77-2.38; P <.001). Independent risk factors of mortality were older age, multiple comorbidities, type of surgery, blood transfusion, and tracheostomy (P <.05, each). Conclusion: Elderly patients currently represent 25% of patients admitted for head and neck surgery. This population should be provided with a different level of care due to a higher risk of complications and mortality.
AB - Objectives: To examine clinical profile and outcomes of elderly patients (65-90 years) undergoing head and neck surgeries in the United States. Study Design: A retrospective cross-sectional analysis. Setting: The Nationwide Readmissions Database, 2010 to 2015. Subjects and Methods: Adult (≥18 years) patients who underwent head and neck surgeries. Analysis included χ2 test and logistic analysis. Results: A total of 113,602 and 32,580 patients <65 and ≥65 years old, respectively, were included. Patients ≥65 years old were more likely to have multiple comorbidities (62.8% vs 32.6%, P <.001) and to present with head and neck cancer (19.8% vs 11.4%, P <.001). The most common comorbidity was diabetes (21.0%). The most common cancer types by site were mouth (29.12%), thyroid (28.08%), and nonmelanoma skin cancer (13.22%). The percentage of geriatric patients who underwent head and neck surgeries increased from 21.8% in 2010 to 25.0% in 2015 (P <.001). A total of 5450 (16.85%) patients developed postoperative complications, and the most common complications were pulmonary related (10.55%), bleeding (6.96%), acute renal failure (6.01%), and infection (3.97%). Blood transfusion was required in 3.53% of the patients. Readmission prevalence was 0.32%, and mortality risk was twice as likely (odds ratio, 2.05; 95% confidence interval, 1.77-2.38; P <.001). Independent risk factors of mortality were older age, multiple comorbidities, type of surgery, blood transfusion, and tracheostomy (P <.05, each). Conclusion: Elderly patients currently represent 25% of patients admitted for head and neck surgery. This population should be provided with a different level of care due to a higher risk of complications and mortality.
KW - complications
KW - elderly patients
KW - epidemiology
KW - geriatric
KW - head and neck cancer
KW - surgery
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U2 - 10.1177/0194599820911727
DO - 10.1177/0194599820911727
M3 - Article
C2 - 32204652
AN - SCOPUS:85082333975
SN - 0194-5998
VL - 163
SP - 335
EP - 343
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 2
ER -