Evaluation Of Comorbidity Scoring Systems In Predicting Postoperative Morbidity And Length Of Hospital Stay In Head And Neck Cancer Patients

Objective: This study aims to identify clinical and socioeconomic factors associated with long-term, post-surgical opioid use in the head and neck cancer population. Methods: A single center retrospective study was conducted including patients diagnosed with head and neck cancer between January 1, 2014 and July 1, 2019 who underwent primary surgical management. The primary outcome measure was continued opioid use 6 months after treatment completion. Both demographic and cancer-related variables were recorded to determine what factors were associated with prolonged opioid use. Univariate analysis was performed using chi-squared test for categorical variables and 2-sample t-test for continuous variables. Multivariate analysis was performed using logistic regression. Results: A total of 359 patients received primary surgical management. Forty-five patients (12.53%) continued to take opioids 6 months after treatment completion. Using univariate analysis, patients less than 65 years of age ( P = .0126), adjuvant chemoradiation (n = 25, P < .001), and overall length of hospital stay (8.60 ± 8.58 days, P = .0274) were significantly associated with long term opioid use. Multivariate logistic regression showed that adjuvant chemoradiation (OR = 3.446, 95% CI [1.742, 6.820], P = .0004) and overall length of hospital stay (OR = 0.949, 95% CI [0.903, 0.997], P = .0373) to be significantly associated with opioid use 6 months after head and neck cancer treatment. Conclusion: Long-term postoperative opioid use in head and neck cancer patients is significantly associated with adjuvant chemoradiation, and patients with longer length of hospital stay. Therefore, future research should focus on interventions to better manage opioid use during the acute treatment period to decrease long-term use.

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Controlling MRSA in Surgical Head&Neck Patients: What Works?

Otolaryngology ◽

10.1016/j.otohns.2008.05.117 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P35-P36

Author(s):

Mrinal Supriya ◽

Louise Santangeli ◽

Muhammad Shakeel ◽

Kim Ah-See

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Hospital Stay ◽

Head And Neck ◽

Cancer Patients ◽

Active Surveillance ◽

Neck Cancer ◽

Case Series ◽

Surveillance Cultures ◽

Increased Risk

Objective Can we control MRSA incidence in head and neck cancer patients by 1) Active surveillance cultures of patients fulfilling Society for Healthcare Epidemiology of America (SHEA) & Scottish Infection Standards and Strategy (SISS) guideline? 2) Cohorting these patients? 3) Restricted Health Care Workers (HCW) access? Methods Prospective case series: July 2007–January 2008. 26 preoperative head and neck cancer patients had a questionnaire filled in to identify known predictors for MRSA as suggested by SISS Group. Intervention: Preoperative nasal swabs, cohorting away from other cases, restricted access. MRSA incidence compared to that over the preceding year(Jan 2006-Jan 2007). Results 26 eligible patients. None of them had known risk factors for MRSA. 17 patients had swabs taken pre-admission. All screened patients were non-carriers of MRSA in their nose and none of them developed MRSA infection during hospital stay. Of remaining 9 patients swabbed after admission, 3 developed MRSA during hospital stay. The incidence of MRSA was 11.5% (3/26) during study period, compared to 28.5% (24/84) the year before implementing these interventions. Conclusions Head and neck cancer patients do not have increased risk factors for MRSA colonization and their active surveillance cultures are unlikely to influence MRSA incidence. Cohorting these patients with restricted HCW access decreased the MRSA rate at our centre.

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The role of antimicrobial prophylaxis in patients with head and neck cancer undergoing chemoradiation

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155219859614 ◽

2019 ◽

Vol 26 (3) ◽

pp. 580-586

Author(s):

Alina T Jaeger ◽

James E Connelly ◽

Ruyun Jin ◽

Samuel N Jacobson ◽

Rom S Leidner

Keyword(s):

Head And Neck Cancer ◽

Hospital Stay ◽

Head And Neck ◽

Neck Cancer ◽

Antimicrobial Prophylaxis ◽

Average Length ◽

Length Of Hospital Stay ◽

National Guidelines ◽

Incidence Of Hospitalization

Background/objective National guidelines do not recommend the routine use of antimicrobial prophylaxis in patients with solid tumors, yet prophylactic agents are still sometimes prescribed for head and neck cancer patients. The purpose of this study is to determine the effect of prophylactic antimicrobials on the incidence of infection in patients undergoing chemoradiation for head and neck cancer. Methods Between 2013 and 2016, patients receiving chemoradiation for head and neck cancer at three outpatient oncology clinics were identified by retrospective review. Cohorts were based on administration or absence of prophylactic antimicrobials. The primary outcome of this study was incidence of infection. Secondary outcomes included incidence of hospitalization and length of hospital stay. Results Seventy-seven patients were analyzed, 47% (n = 36) were not prescribed antimicrobial prophylaxis and 53% (n = 41) were prescribed prophylaxis. Infection occurred in 31 patients in the no prophylaxis cohort and in 34 patients in the prophylaxis cohort (86.1% vs. 82.9%, p = 0.945). Twenty patients in the no prophylaxis cohort were hospitalized versus 16 patients in the prophylaxis cohort ( p = 0.222). The average length of hospital stay was 6 days in the no prophylaxis cohort and 10.6 days in the prophylaxis cohort ( p = 0.007). Conclusion The use of antimicrobial prophylaxis did not significantly impact the incidence of infection when compared to patients who were not prescribed prophylaxis. There was no difference in the incidence of hospitalization, however, the patients in the prescribed prophylactic group had longer length of hospital stay.

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Effect of Early Individualized Dietary Counseling on Weight Loss, Complications, and Length of Hospital Stay in Patients With Head and Neck Cancer: A Comparative Study

Nutrition and Cancer ◽

10.1080/01635581.2015.1073755 ◽

2015 ◽

Vol 67 (7) ◽

pp. 1093-1103 ◽

Cited By ~ 7

Author(s):

Eva Leistra ◽

Simone E. J. Eerenstein ◽

Loes H. van Aken ◽

Femke Jansen ◽

Marian A. E. de van der Schueren ◽

...

Keyword(s):

Weight Loss ◽

Head And Neck Cancer ◽

Comparative Study ◽

Hospital Stay ◽

Head And Neck ◽

Neck Cancer ◽

Length Of Hospital Stay ◽

Dietary Counseling

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Effect of perioperative nutrition, with and without arginine supplementation, on nutritional status, immune function, postoperative morbidity, and survival in severely malnourished head and neck cancer patients

American Journal of Clinical Nutrition ◽

10.1093/ajcn/73.2.323 ◽

2001 ◽

Vol 73 (2) ◽

pp. 323-332 ◽

Cited By ~ 101

Author(s):

Marian AE van Bokhorst-de van der Schueren ◽

Jasper J Quak ◽

B Mary E von Blomberg-van der Flier ◽

Dirk J Kuik ◽

Sterre I Langendoen ◽

...

Keyword(s):

Head And Neck Cancer ◽

Nutritional Status ◽

Immune Function ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Postoperative Morbidity ◽

Perioperative Nutrition ◽

Arginine Supplementation

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How does tracheostomy affect length of hospital stay in head and neck cancer?

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.bjoms.2017.08.059 ◽

2017 ◽

Vol 55 (10) ◽

pp. e104

Author(s):

Hussein Mohamedbhai ◽

Suraj Thomas ◽

Lara Watson ◽

Colin Liew ◽

Iain Hutchinson ◽

...

Keyword(s):

Head And Neck Cancer ◽

Hospital Stay ◽

Head And Neck ◽

Neck Cancer ◽

Length Of Hospital Stay

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The rate of phrenic nerve injury following neck dissection for head and neck cancer and its impact on length of hospital stay

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2017.02.954 ◽

2017 ◽

Vol 46 ◽

pp. 283 ◽

Cited By ~ 1

Author(s):

O. Dugena ◽

S. Islam ◽

J. Hayter

Keyword(s):

Head And Neck Cancer ◽

Hospital Stay ◽

Head And Neck ◽

Neck Dissection ◽

Nerve Injury ◽

Neck Cancer ◽

Phrenic Nerve ◽

Length Of Hospital Stay ◽

Phrenic Nerve Injury

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Bronchoscopy in panendoscopy: review and assessment

The Journal of Laryngology & Otology ◽

10.1017/s0022215115002856 ◽

2015 ◽

Vol 129 (12) ◽

pp. 1220-1223 ◽

Cited By ~ 2

Author(s):

A Shahangian ◽

E J Damrose

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Case Series ◽

Length Of Hospital Stay ◽

Clinical Information ◽

Pathology Reports ◽

The Individual ◽

Operative Findings

AbstractObjective:To determine the utility of bronchoscopy to identify synchronous primaries in head and neck cancer patients.Study design:Case series with chart review.Method:The charts of all patients undergoing bronchoscopy between January 2008 and December 2013 were reviewed. Only those undergoing bronchoscopy as part of panendoscopy for head and neck cancer were included. Operative reports, pathology reports and discharge summaries were reviewed for operative findings, complications and length of hospital stay.Results:A total of 404 charts were reviewed and 168 were included in the study. No synchronous primaries were identified. Bronchoscopy changed clinical management in one patient. There were no complications from bronchoscopy.Conclusion:Bronchoscopy is a safe and well-tolerated procedure commonly performed in the investigation of head and neck cancer patients, but it adds little additional useful clinical information. Routine performance of bronchoscopy in this setting should be weighed against its added costs, and tailored to the individual patient.

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