Effect of comorbidity on short-term outcomes and cost of care after head and neck cancer surgery in the elderly

Background With increased life expectancy, there is growing awareness of the effect of comorbidity on physiologic reserves in elderly patients. Data in the area of head and neck cancer surgery is lacking. Methods Retrospective data from 61,740 elderly patients who underwent a head and neck cancer ab...

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Bibliographic Details
Published in:Head & neck 2015-05, Vol.37 (5), p.685-693
Main Authors: Genther, Dane J., Gourin, Christine G.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - economics
Carcinoma, Squamous Cell - epidemiology
Carcinoma, Squamous Cell - surgery
Comorbidity
Confidence Intervals
Cross-Sectional Studies
Databases, Factual
elderly
Female
Follow-Up Studies
Geriatric Assessment
head and neck neoplasms
Head and Neck Neoplasms - economics
Head and Neck Neoplasms - epidemiology
Head and Neck Neoplasms - surgery
Hospital Costs
Hospital Mortality
Humans
Length of Stay - economics
Male
Nationwide Inpatient Sample
Odds Ratio
Postoperative Complications - economics
Postoperative Complications - therapy
Retrospective Studies
surgery
Time Factors
Treatment Outcome
United States
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Summary:Background With increased life expectancy, there is growing awareness of the effect of comorbidity on physiologic reserves in elderly patients. Data in the area of head and neck cancer surgery is lacking. Methods Retrospective data from 61,740 elderly patients who underwent a head and neck cancer ablative surgery from 2001 to 2010 using the Nationwide Inpatient Sample were analyzed to examine associations between comorbidity and in‐hospital mortality, postoperative complications, length of hospitalization, and hospital‐related costs. Results Advanced comorbidity was present in 18% of elderly patients, who were more likely to experience acute medical complications (odds ratio [OR], 3.7; p < .001), in‐hospital death (OR, 3.6; p < .001), increased length of hospitalization (mean, 2.2 days; p < .001), and hospital‐related costs (mean, $6874; p < .001). Conclusion Advanced comorbidity in elderly surgical patients with head and neck cancer is associated with increased mortality, morbidity, length of hospitalization, and hospital‐related costs. This increased utilization of health care resources may pose challenges to health care reform efforts as the population ages. © 2014 Wiley Periodicals, Inc. Head Neck 37: 685–693, 2015
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.23651