Outcomes of head and neck cancer surgery in the geriatric population based on case volume at academic centers
- 12 July 2017
- journal article
- research article
- Published by Wiley in The Laryngoscope
- Vol. 127 (11), 2539-2544
- https://doi.org/10.1002/lary.26750
Abstract
Evaluate the impact of case volume and other variables on cost and mortality after head and neck oncologic surgery in the geriatric population. Cross-sectional study. The Vizient database was accessed for data on geriatric patients (age ≥65 years) who underwent surgery for head and neck cancers (excluding thyroid and skin cancer) at full member academic medical centers between 2009 and 2012. Multivariate, linear regression analyses, χ2 tests, and analysis of variance were applied to evaluate significant associations between hospital case volume and independent variables including cost, cost index, mortality, mortality index, length of stay, length of stay index, and readmission rates. A total of 4,544 patients were included. Total length of stay was 6.72 days in high-volume hospitals, compared to 8.12 days and 7.91 days in moderate- and low-volume hospitals, respectively (P = .0144). Frequency of intensive care unit stays was 36.5% in high-volume hospitals, compared to 42.19% and 40.29% in moderate- and low-volume hospitals, respectively (P = .0048). Mortality (0.78%) and average cost per case ($21,834) was lower, but nonsignificant in high-volume hospitals. Using multiple regression analysis, major severity of disease was positively associated with complication rate (P < .0001) and length of stay (P = .0481). After controlling for other factors, high-volume academic medical centers have a lower intensive care unit stay, but no difference in mortality or average cost per case when compared to low-volume hospitals. 2b Laryngoscope, 2017Keywords
This publication has 27 references indexed in Scilit:
- Interventions to Reduce 30-Day Rehospitalization: A Systematic ReviewAnnals of Internal Medicine, 2011
- Operative Outcomes Beyond 30-day MortalityAnnals of Surgery, 2011
- Determinants of head and neck cancer survival by raceHead & Neck, 2010
- The increasing workload in head and neck surgery: An epidemiologic analysisThe Laryngoscope, 2010
- African American and poor patients have a dramatically worse prognosis for head and neck cancerCancer, 2008
- High-Volume versus Low-Volume for Esophageal Resections for Cancer: The Essential Role of Case-Mix Adjustments based on Clinical DataAnnals of Surgical Oncology, 2007
- The relationship of surgeon and hospital volume to outcome after gastric bypass surgery in Pennsylvania: A 3-year summarySurgery, 2003
- Barriers to Clinical Trial Participation by Older Women With Breast CancerJournal of Clinical Oncology, 2003
- Enrollment of Older Patients in Cancer Treatment Trials in Canada: Why is Age a Barrier?Journal of Clinical Oncology, 2003
- Hospital Volume and Surgical Mortality in the United StatesNew England Journal of Medicine, 2002