Discharge Disposition After Head and Neck Reconstruction: Effect on Adjuvant Therapy and Outcomes

Objectives Head and neck cancer patients that require major reconstruction often have advanced‐stage disease. Discharge disposition of patients can vary and impact time to adjuvant treatment. We sought to examine outcomes in patients discharged to skilled nursing facilities (SNF) compared to those d...

Full description

Saved in:
Bibliographic Details
Published in:The Laryngoscope 2023-11, Vol.133 (11), p.2977-2983
Main Authors: Dang, Sophia, Patel, Terral, Lao, Isabella, Sridharan, Shaum S., Solari, Mario G., Kim, Seungwon, Duvvuri, Umamaheswar, Ferris, Robert, Kubik, Mark
Format: Article
Language:English
Subjects:
adjuvant therapy
Cancer therapies
Discharge
disposition
Head & neck cancer
head and neck
microvascular free flap
Radiation therapy
readmission
reconstruction
skilled nursing facility
treatment package time
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives Head and neck cancer patients that require major reconstruction often have advanced‐stage disease. Discharge disposition of patients can vary and impact time to adjuvant treatment. We sought to examine outcomes in patients discharged to skilled nursing facilities (SNF) compared to those discharged home, including the impact on adjuvant therapy initiation and treatment package time (TPT). Methods Patients with head and neck squamous cell carcinoma treated with surgical resection and microvascular free flap reconstruction from 2019 to 2022 were included. Retrospective review was conducted to evaluate the impact of disposition on time to radiation (RT) and TPT. Results 230 patients were included, with 165 (71.7%) discharged to home and 65 (28.3%) discharged to SNF. 79.1% of patients were recommended adjuvant therapy. Average time to RT was 59 days for patients discharged to home compared to 70.1 days for patients discharged to SNF. Disposition was an independent risk factor for delays to starting RT (p = 0.03). TPT was 101.7 days for patients discharged to home versus 112.3 days for those who discharged to SNF. Patients discharged to SNF had higher rates of readmission (p 
ISSN:0023-852X
1531-4995
1531-4995
DOI:10.1002/lary.30648