Genther Dane J, Gourin Christine G
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Head Neck. 2015 May;37(5):685-93. doi: 10.1002/hed.23651. Epub 2014 May 2.
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.
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.
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).
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.
随着预期寿命的增加，人们越来越意识到合并症对老年患者生理储备的影响。头颈部癌手术领域的数据尚缺。
利用全国住院患者样本分析了2001年至2010年接受头颈部癌根治性手术的61740例老年患者的回顾性数据，以研究合并症与住院死亡率、术后并发症、住院时间和医院相关费用之间的关联。
18%的老年患者存在严重合并症，这些患者更有可能发生急性医疗并发症（比值比[OR]，3.7；p <.001）、住院死亡（OR，3.6；p <.001）、住院时间延长（平均2.2天；p <.001）以及医院相关费用增加（平均6874美元；p <.001）。
老年头颈部癌手术患者的严重合并症与死亡率、发病率、住院时间和医院相关费用增加有关。随着人口老龄化，这种医疗资源利用的增加可能给医疗改革带来挑战。
