Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Division of Otolaryngology - Head and Neck Surgery and Communicative Disorders, Prisma Health Upstate, Greenville, South Carolina, USA.
Head Neck. 2022 Jul;44(7):1655-1664. doi: 10.1002/hed.27070. Epub 2022 Apr 29.
The association of comorbidities with perioperative outcomes after transoral robotic surgery (TORS) is not well-defined in the literature.
Using the National Cancer Database, 4004 patients with T1-T2 oropharyngeal cancer between 2010 and 2017 were stratified based on their Charlson-Deyo Comorbidity Class (CDCC). Thirty-day unplanned readmissions, 30-day mortality, and 90-day mortality were compared using chi-square test and logistic regression. Hospital length of stay (LOS) was compared using the Kruskal-Wallis test.
LOS was greater for patients with CDCC 2 or 3 compared to CDCC 0 or 1 (p < 0.001). Increasing age and CDCC ≥3 were associated with 30-day mortality (CDCC ≥3: odds ratio [OR] 5.55, 95% confidence interval [CI] 1.59-19.45). CDCC ≥3 (OR 2.61, 95%CI 1.09-6.27) was significantly associated with 30-day readmissions.
This national analysis demonstrates greater rates of unplanned 30-day readmissions, longer hospitalizations, and increased 30- and 90-day mortality after TORS in patients with CDCC ≥3.
关于合并症与经口机器人手术（TORS）术后结果之间的关系，文献中尚无明确的定义。
利用国家癌症数据库，对 2010 年至 2017 年间的 4004 例 T1-T2 口咽癌患者根据 Charlson-Deyo 合并症指数（CDCC）进行分层。使用卡方检验和逻辑回归比较 30 天内非计划性再入院、30 天死亡率和 90 天死亡率。使用 Kruskal-Wallis 检验比较住院时间（LOS）。
与 CDCC 0 或 1 相比，CDCC 2 或 3 的患者 LOS 更长（p<0.001）。年龄增加和 CDCC≥3 与 30 天死亡率相关（CDCC≥3：比值比[OR]5.55，95%置信区间[CI]1.59-19.45）。CDCC≥3（OR 2.61，95%CI 1.09-6.27）与 30 天内再入院显著相关。
这项全国性分析表明，CDCC≥3 的患者在接受 TORS 后，30 天内非计划性再入院、住院时间延长和 30 天及 90 天死亡率更高。
