Presentation and Outcomes of Elderly Patients Undergoing Head and Neck Surgeries: A National Perspective

Zaid Al-Qurayshi, Christopher Blake Sullivan, Adam Schwalje, Jarrett Walsh, Rodrigo Bayon, Ralph Tufano, Emad Kandil

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)335-343
Number of pages9
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume163
Issue number2
DOIs
StatePublished - Aug 1 2020

Keywords

  • complications
  • elderly patients
  • epidemiology
  • geriatric
  • head and neck cancer
  • surgery

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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