Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;160(4):664-671.
doi: 10.1177/0194599818825466. Epub 2019 Jan 29.

Frailty as a Predictor of Postoperative Outcomes among Patients with Head and Neck Cancer

Kristen D Pitts  1 , Alberto A Arteaga  1 , Benjamin P Stevens  1 , William C White  1 , Dan Su  1   2 , Christopher Spankovich  1 , Gina D Jefferson  1 , Lana L Jackson  1
Affiliations

Frailty as a Predictor of Postoperative Outcomes among Patients with Head and Neck Cancer

Kristen D Pitts et al. Otolaryngol Head Neck Surg. 2019 Apr.

Abstract

Objectives: To understand measures of frailty among preoperative patients and explain how these can predict perioperative outcomes among patients with head and neck cancer.

Study design: Retrospective cross-sectional case series with chart review.

Setting: Academic tertiary medical center.

Subjects and methods: A retrospective review was performed of patients presenting to an academic hospital following a surgical procedure for a head and neck cancer diagnosis. Charts were queried for preoperative medical diagnoses to calculate 2 frailty scores: the American College of Surgeons National Surgical Quality Improvement Program modified frailty index and the Johns Hopkins Adjusted Clinical Groups frailty index. The American Society of Anesthesiologists classification system was also analyzed as a predictor. Primary outcomes were mortality, 30-day readmission, and length of stay. Perioperative complications and discharge disposition were also evaluated.

Results: A total of 410 charts were queried between January 2014 and December 2017. Mortality was 11%; mean ± SD length of stay was 7.4 ± 5.5 days; and the readmission rate was 17%. The modified frailty index score significantly increased the odds of mortality (odds ratio = 1.475, P = .012) and readmission (odds ratio = 1.472, P = .004), the length of stay (relative risk = 1.136, P = .001), and the number of perioperative complications. The American Society of Anesthesiologists classification was also significantly associated with poor outcomes, including readmission, length of stay, and perioperative complications. The Adjusted Clinical Groups index was not a significant predictor of outcomes in this study population.

Conclusions: This study demonstrated a significant increase in poor perioperative outcomes and mortality among patients with head and neck cancer and increased frailty, as measured by the modified frailty index.

Keywords: comorbidity; frailty; head and neck cancer; perioperative outcomes; risk stratification; surgical outcomes.

PubMed Disclaimer

LinkOut - more resources