Thompson Emma R, Abdel-Azim Nour, Yan Kenneth
Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA.
Department of Otolaryngology Loma Linda University Health Loma Linda California USA.
Laryngoscope Investig Otolaryngol. 2025 Sep 17;10(5):e70257. doi: 10.1002/lio2.70257. eCollection 2025 Oct.
Malnutrition and weight loss in patients with laryngeal cancer impair immune function and wound healing. Understanding how underweight status impacts outcomes is crucial to improving care. Accordingly, we evaluated perioperative outcomes of patients undergoing laryngectomy for laryngeal cancer, with a secondary focus on patients with recent unintentional weight loss.
This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database. CPT codes were used to identify patients undergoing open total or partial laryngectomies for cancer. Only those with underweight (< 18.5) or normal weight (18.5-29.9) BMIs were included. A subgroup analysis assessed patients with recent unintentional weight loss. Univariate and multivariate analyses were performed, with significance set at < 0.05.
2012 patients were analyzed: 276 underweight (79 female, 197 male) and 1736 normal weight (306 female, 1430 male). Age distribution among underweight patients was 2.5% (ages 20-44), 76.1% (ages 45-69), and 21.4% (ages 70-90), compared to 2.9%, 66.7%, and 30.1%, respectively, in normal-weight patients. Underweight patients were more likely to experience medical complications ( < 0.001), longer hospital stays ( < 0.001), wound disruptions ( = 0.002), and to have greater transfusion requirements ( < 0.001). In those with recent, unintentional weight loss, underweight individuals were at increased risk of experiencing medical complications ( = 0.046) and requiring a transfusion ( < 0.001), but were not more likely to experience wound disruptions ( = 0.119) or experience increased lengths of stay ( = 0.225).
Underweight status and recent weight loss are associated with heightened risks of perioperative medical complications and transfusions. Preoperative optimization may enhance surgical recovery and outcomes.
Level 3.
喉癌患者的营养不良和体重减轻会损害免疫功能和伤口愈合。了解体重过轻状态如何影响治疗结果对于改善护理至关重要。因此，我们评估了接受喉癌喉切除术患者的围手术期结果，次要重点是近期非故意体重减轻的患者。
这项回顾性队列研究使用了美国外科医师学会国家外科质量改进计划数据库。使用CPT编码识别接受开放性全喉或部分喉切除术治疗癌症的患者。仅纳入体重过轻（<18.5）或体重正常（18.5 - 29.9）的BMI患者。亚组分析评估近期非故意体重减轻的患者。进行单因素和多因素分析，显著性设定为<0.05。
分析了2012例患者：276例体重过轻（79例女性，197例男性）和1736例体重正常（306例女性，1430例男性）。体重过轻患者的年龄分布为2.5%（20 - 44岁）、76.1%（45 - 69岁）和21.4%（70 - 90岁），而体重正常患者分别为2.9%、66.7%和30.1%。体重过轻的患者更有可能出现医疗并发症（<0.001）、住院时间更长（<0.001）、伤口裂开（=0.002）以及输血需求更大（<0.001）。在近期非故意体重减轻的患者中，体重过轻的个体出现医疗并发症（=0.046）和需要输血（<0.001）的风险增加，但伤口裂开（=0.119）或住院时间延长（=0.225）的可能性并不更高。
体重过轻状态和近期体重减轻与围手术期医疗并发症和输血风险增加相关。术前优化可能会提高手术恢复和治疗结果。
3级。
