Effect of comorbidity on short-term outcomes and cost of care after head and neck cancer surgery in the elderly

Head Neck. 2015 May;37(5):685-93. doi: 10.1002/hed.23651. Epub 2014 May 2.

Abstract

Background: With increased life expectancy, there is growing awareness of the effect of comorbidity on physiologic reserves in elderly patients. Data in the area of head and neck cancer surgery is lacking.

Methods: Retrospective data from 61,740 elderly patients who underwent a head and neck cancer ablative surgery from 2001 to 2010 using the Nationwide Inpatient Sample were analyzed to examine associations between comorbidity and in-hospital mortality, postoperative complications, length of hospitalization, and hospital-related costs.

Results: Advanced comorbidity was present in 18% of elderly patients, who were more likely to experience acute medical complications (odds ratio [OR], 3.7; p < .001), in-hospital death (OR, 3.6; p < .001), increased length of hospitalization (mean, 2.2 days; p < .001), and hospital-related costs (mean, $6874; p < .001).

Conclusion: Advanced comorbidity in elderly surgical patients with head and neck cancer is associated with increased mortality, morbidity, length of hospitalization, and hospital-related costs. This increased utilization of health care resources may pose challenges to health care reform efforts as the population ages.

Keywords: Nationwide Inpatient Sample; comorbidity; elderly; head and neck neoplasms; surgery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / economics*
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / surgery*
  • Comorbidity*
  • Confidence Intervals
  • Cross-Sectional Studies
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Head and Neck Neoplasms / economics*
  • Head and Neck Neoplasms / epidemiology
  • Head and Neck Neoplasms / surgery*
  • Hospital Costs*
  • Hospital Mortality
  • Humans
  • Length of Stay / economics
  • Male
  • Odds Ratio
  • Postoperative Complications / economics
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • United States