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探讨性分析心理健康障碍与头颈部癌症手术住院术后并发症和死亡率的关联。

Exploratory analysis on the association of mental health disorders with in-hospital postoperative complications and mortality in head and neck cancer surgery.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

出版信息

Head Neck. 2021 Oct;43(10):3022-3031. doi: 10.1002/hed.26791. Epub 2021 Jun 28.

Abstract

BACKGROUND

The objective was to assess the association of mental health disorders with in-hospital complication and mortality rates in patients undergoing head and neck cancer surgery.

METHODS

In this exploratory retrospective study, the Nationwide Inpatient Sample was queried from 2003 to 2014 for all patients with a diagnosis of head and neck cancer who underwent surgery. Univariate cross-tabulation, logistic regression, and propensity score matching (PSM) were used to compare demographics, procedure-related variables, and in-hospital postoperative complications and mortality between patients with and without selected comorbid mental health disorders.

RESULTS

Of 39 600 included patients, 3390 (8.6%) had a selected comorbid mental health disorder diagnosis. After PSM, patients with selected mental health disorders had increased risk of overall medical complications on multivariable analysis (OR 1.28 [CI 1.12-1.46], P < 0.001) but not overall surgical complications or mortality.

CONCLUSIONS

Patients with a mental health disorder diagnosis have increased risk of in-hospital medical, certain surgical, and total complications.

摘要

背景

本研究旨在评估心理健康障碍与头颈部癌症手术患者的住院并发症和死亡率之间的关系。

方法

在这项探索性回顾性研究中,我们从 2003 年至 2014 年在全国住院患者样本中查询了所有接受手术治疗的头颈部癌症患者的诊断信息。我们使用单变量交叉表、逻辑回归和倾向评分匹配(PSM)来比较伴有或不伴有选定合并症的心理健康障碍患者的人口统计学、手术相关变量以及住院术后并发症和死亡率。

结果

在纳入的 39600 例患者中,有 3390 例(8.6%)患者被诊断为患有选定的合并症心理健康障碍。经过 PSM 后,多变量分析显示伴有选定精神健康障碍的患者发生总体医疗并发症的风险增加(OR 1.28 [CI 1.12-1.46],P < 0.001),但手术相关并发症或死亡率没有增加。

结论

患有心理健康障碍诊断的患者有更高的住院期间医疗、特定手术和总并发症风险。

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