Disability level as a key predictor of mortality in patients with oral cancer: A hospital-based retrospective study in Taiwan.

Abstract

Background: This study investigated the demographics, comorbidities, and mortality rates of patients diagnosed with oral cancer, guided by a hypothesis that disability level would emerge as an independent predictor of adverse outcomes alongside age and comorbidities.

Methods: Socio-demographic and medical information for patients treated for oral cancer at National Taiwan University Hospital (NTUH) from 2012 to 2018 was collected, along with their mortality data from NTUH's integrated medical database. Disability levels were measured using WHODAS 2.0, dividing patients into severe (WHODAS score ≥60, n = 197) and non-severe disability (WHODAS score ≤59, n = 228) groups. The primary outcome was overall survival probability. Propensity-score matching balanced baseline characteristics, and Cox proportional-hazard models analyzed the impact of various covariates on mortality rates.

Results: A total of 425 patients diagnosed with oral cancer were enrolled in the study, with a mean age of 55.1 years (standard deviation, 9.8). The majority (95 %) were men. Over the 6.75-year data-collection window, 94 of them (22.1 %) died. The severely disabled group exhibited significantly poorer survival (p = 0.02), and univariate analyses identified WHODAS scores of 60 or higher as an independent prognostic factor among patients with oral cancer (hazard ratio = 1.59, 95 % confidence interval = [1.05-2.40]).

Conclusion: WHODAS 2.0 scores of 60 or higher indicate severe to extreme disability, which often correlates with poorer overall health and reduced ability to manage oral cancer and its treatments. This significant impairment is likely to be a contributory factor in higher mortality rates amongst this patient group.