br Table br Sex br Male Prior cancer history
Male 75 Prior cancer history 9 Neo-adjuvant treatment
Chemotherapy < 1
History of psychiatric illness 11 Chemoradiation 3 Ethnicity
None 96 Hispanic 4 Smoking history
Non-Hispanic 75 Never smoked 41 Prophylactic PEG Placement 11 Unknown 21 Former smoker 46
Current smoker 13 Prophylactic NG tube placement 2 Marital status
Married 73 Alcohol history
PEG placed prior to hospital discharge 30 Not married 27 Never 37
Active drinker – social 52 PEG placed after hospital discharge 13 Type of HNC
Active drinker – abuse 10
Oral cavity 36 Former Drinker 4 Tracheostomy 37 Oropharynx 41
Hypopharynx 2 History of illicit drug use 6 TORS 18 Larynx 14
Paranasal Sinus and Nasal Cavity 2 Food intake in past month
Salivary gland 5 Unchanged or more than usual 74 Radiation 26
Less than usual 26 Chemoradiation 20 Stage at Diagnosis
None 54 I 22 Comorbidities
II 17 Chronic Pulmonary Disease 5
III 19 Chronic Artery Disease 12
IV 42 Hypertension 51
Hepatic disease 4
Vascular disease < 1
Not tested 61 Hypothyroidism 12
P16 Positive 27 Diabetes 14
P16 Negative 12 GI problems 15
Renal disease < 1
Neurological disorder 8
Note: x2 = Chi-Square; HNC = Head and Neck Cancer; PEG = percutaneous endoscopic gastrostomy tube; TORS = Transoral Robotic Surgery, EMR = elec.
Hospital readmissions and ED visits are within 30 days of initial discharge following HNC surgery.
Univariate regressions showed that MK-2206 type of HNC (specifically, lar-yngeal cancer), experiencing reduced food intake in the month prior to surgery, having lower MDADI and UW-QOL composite scores at the surgical consult visit, having a prior smoking history and/or history of cancer, undergoing open as opposed to robotic (TORS) surgery, ex-periencing a surgical complication (inpatient or outpatient), and having a PEG or tracheostomy were all independently significantly associated with increased LOS (p ≤.05). A stepwise multiple regression analysis was then performed to predict LOS from these eight variables. After a backward elimination process, the final model revealed that MDADI and UW-QOL composite scores, documented surgical complications, and having a tracheostomy significantly predicted LOS, F(5, 160) = 18.71 p < .001, R2 = 0.57 (see Table 2).
Given thylakoids surgical site infections in HNC microvascular construc-tion remain a significant postoperative complication and could possibly confound findings for LOS, we combed through the EHR and identified 4 patients who underwent microvascular construction. LOS ranged from 11 to 29 days, which is significantly higher than the average LOS for the overall sample. Based on this, analyses were re-run with these cases removed, but the overall findings did not significantly change.
Of all the predictor variables that were examined, univariate
Final multivariate linear regression model for LOS.
B SE t Lower Upper Adjusted R2
Type of HNC – – – – – Food Intake Decrease – – – – – in past month
Note: Hx = History HNC = Head and Neck Cancer; MDADI = M D Anderson Dysphagia Inventory; UWQOL = University of Washington Quality of Life survey; PEG = percutaneous endoscopic gastrostomy Tube; TORS = Transoral Robotic Surgery.
regressions showed that only male gender, having a documented psy-chiatric history, lower MDADI composite scores prior to surgery, and having a PEG were independently significantly associated with 30dURs (p ≤ .05). When these variables were collectively entered in a multi-variate logistic regression model using backward stepwise elimination (see Table 3), findings showed that 30dURs were only significantly r> Table 3
Final multivariate logistic regression models for unplanned readmissions and ED visits.
95% Confidence Interval
B P-value OR Lower Upper Adjusted R2
Surgical Complications – – – – –
Tracheostomy – – – – –
Note: Hx = History HNC = Head and Neck Cancer; MDADI = M D Anderson Dysphagia Inventory; PEG = percutaneous endoscopic gastrostomy Tube, Dx = diagnosis.
Univariate regressions showed that lower pre-surgical MDADI scores, having more advanced stage disease, requiring a tracheostomy, and experiencing surgical complications were significantly in-dependently associated with ED visits (p ≤.05). When these variables were collectively entered in a multivariate logistic regression model with backward stepwise elimination (see Table 3), the only significant predictor of ED visits was MDADI composite scores (OR 0.94; 95% CI 0.88–0.92; p = .02).