Impact of Dementia on the Postoperative Outcomes in Patients Undergoing Surgery for Head and Neck Cancers: A National Study

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2023-08-21 DOI:10.1002/lary.30988

Rema Anisha Kandula MD, Grant Borne BS, Sandeep Kandregula MD, Robbie Beyl PhD, Cherie-Ann O. Nathan MD

{"title":"Impact of Dementia on the Postoperative Outcomes in Patients Undergoing Surgery for Head and Neck Cancers: A National Study","authors":"Rema Anisha Kandula MD, Grant Borne BS, Sandeep Kandregula MD, Robbie Beyl PhD, Cherie-Ann O. Nathan MD","doi":"10.1002/lary.30988","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>Dementia, a growing concern among the elderly, has an increased poor postoperative outcome that goes unrecognized by many. Our study aims to establish if dementia plays a role in the outcomes of head and neck cancer patients that undergo resections.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We queried the National Inpatient Sample (NIS) database from 2016 to 2019 with a primary diagnosis of head and neck cancer who underwent surgical resection. Outcomes analyzed include postoperative delirium, ICU stay, complications, length of stay, and non-routine discharge.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 77095 patients were included, of which 1140 patients had dementia. The mean age of the patients with dementia was 77.5 years (±9.1) versus 63.2 years (±12.1) with no dementia. Dementia patients had a higher non-home discharge rate (77.2% vs 46.8%, <i>p</i> = <0.001), extended length of stay (10.9 days ±14.7 vs 7.9 days ±8.8), postoperative delirium (15.4% vs 1.5%, <i>p</i> = <0.001), and longer ICU stay (8.3% vs 5.8%) as compared with patients with no dementia. A higher number of patients with Dementia were placed in long-term facilities (53.5% vs 14.6%) postoperatively. More dementia patients (7.9% vs 0.9%) were transferred in from another health care facility for surgery. Dementia was associated with higher odds of delirium (OR, 6.36; 95% CI, 5.2–7.77), non-routine discharge (OR, 2.05; 95% CI, 1.76–2.3), ventilation (OR, 0.8; 95% CI, 0.6–1.05), and length of stay (estimate 3.01, 95% CI, 1.84–4.184).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Preoperative dementia significantly impacts postoperative delirium, non-home discharge, and extended length of stay in head and neck cancer patients undergoing surgery.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>3 <i>Laryngoscope</i>, 134:1258–1264, 2024</p>\n </section>\n </div>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":"134 3","pages":"1258-1264"},"PeriodicalIF":2.0000,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/lary.30988","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Dementia, a growing concern among the elderly, has an increased poor postoperative outcome that goes unrecognized by many. Our study aims to establish if dementia plays a role in the outcomes of head and neck cancer patients that undergo resections.

Methods

We queried the National Inpatient Sample (NIS) database from 2016 to 2019 with a primary diagnosis of head and neck cancer who underwent surgical resection. Outcomes analyzed include postoperative delirium, ICU stay, complications, length of stay, and non-routine discharge.

Results

A total of 77095 patients were included, of which 1140 patients had dementia. The mean age of the patients with dementia was 77.5 years (±9.1) versus 63.2 years (±12.1) with no dementia. Dementia patients had a higher non-home discharge rate (77.2% vs 46.8%, p = <0.001), extended length of stay (10.9 days ±14.7 vs 7.9 days ±8.8), postoperative delirium (15.4% vs 1.5%, p = <0.001), and longer ICU stay (8.3% vs 5.8%) as compared with patients with no dementia. A higher number of patients with Dementia were placed in long-term facilities (53.5% vs 14.6%) postoperatively. More dementia patients (7.9% vs 0.9%) were transferred in from another health care facility for surgery. Dementia was associated with higher odds of delirium (OR, 6.36; 95% CI, 5.2–7.77), non-routine discharge (OR, 2.05; 95% CI, 1.76–2.3), ventilation (OR, 0.8; 95% CI, 0.6–1.05), and length of stay (estimate 3.01, 95% CI, 1.84–4.184).

Conclusion

Preoperative dementia significantly impacts postoperative delirium, non-home discharge, and extended length of stay in head and neck cancer patients undergoing surgery.

Level of Evidence

3 Laryngoscope, 134:1258–1264, 2024

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

痴呆症对头颈部癌症手术患者术后效果的影响：一项全国性研究。

背景：痴呆症是老年人日益关注的一个问题，其术后不良预后会增加，但很多人并未意识到这一点。我们的研究旨在确定痴呆症是否会影响接受切除手术的头颈部癌症患者的预后：我们查询了 2016 年至 2019 年期间的全国住院患者样本（NIS）数据库，这些患者主要诊断为头颈部癌症，并接受了手术切除。分析的结果包括术后谵妄、入住重症监护室、并发症、住院时间和非例行出院：共纳入 77095 名患者，其中 1140 名患者患有痴呆症。痴呆症患者的平均年龄为 77.5 岁（±9.1）岁，而非痴呆症患者的平均年龄为 63.2 岁（±12.1）岁。痴呆症患者的非居家出院率较高（77.2% vs 46.8%，P = 结论：术前痴呆对接受手术的头颈部癌症患者的术后谵妄、非居家出院和住院时间的延长有很大影响：3 《喉镜》，134:1258-1264，2024。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects