Abstract
Background : This study analyzed the effects of four candidate prognostic factors on length of hospital stay among inpatients following thyroid cancer resection; specifically, age ≥ 45 years, cervical lymph node metastasis, impaired calcium metabolism, and postoperative hypothyroidism.Methods : This was a retrospective study reviewing 434 patients’ medical and claim records (n=434; male 21.0%/female 79.0%, age: 57.31±13.52). Results : Patients who met one of the four prognostic criteria were more likely to have a longer hospital stay using acute-care beds than corresponding cases negative for these criteria. Regression analysis indicated that patient’s length of hospital stay was increased with each factor by the following rates: 1) 14.57% if 45 years or older, 2) 26.24% if positive for cervical lymph node metastasis, 3) 28.79% if positive for impaired calcium metabolism, and 4) 29.95% if positive for postoperative hypothyroidism. Moreover, estimations of cumulative probability of length of hospital stay indicate that: 1) 26.6% of the age≥45 patient group is expected to be discharged by the 7 th day in contrast to 42.9% of age<45 patient group (91.0%,97.4% at 14 th day); 2) 16.1% of the cervical lymph node metastasis patient group is expected to be discharged by the 7 th day in contrast with 30.5% of non-patient group (83.9%,92.8% at 14 th day); 3) 14.8% of the impaired calcium metabolism patient group is expected to be discharged by the 7 th day in contrast with 30.5% of non-patient group (70.4%,93.6% at 14 th day), and 4) 21.4% of the postoperative hypothyroidism patient group is expected to be discharged by the 7 th day in contrast with 29.8% of non-patient group (71.4%,92.9% at 14 th day). Conclusions : Disorders of calcium metabolism and postoperative hypothyroidism were the most likely postoperative complications to occur, yet these are not identified as prognostic factors in the Diagnosis Procedure Combination / Per-Diem Payment System (DPC/PDPS) framework in Japan. The findings suggest that patients with these two conditions should receive care in beds of a lower, sub-acute category, and they should be quickly transferred to such beds or, if possible, to outpatient care.
Prognostic factors for cervical lymph node metastasis from head and neck squamous cell carcinoma of the skin: A single centre retrospective analysis
