Does discharge location following head and neck cancer surgery affect quality outcomes?

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2026-04-01 Epub Date: 2026-02-11 DOI:10.1016/j.oraloncology.2026.107879

Cristina Benites , Colyn White , Logesvar Balaguru , Liu Gonghao , Ji-Hyun Lee , Dustin J. Conrad , Austin Lam , Peter T. Dziegielewski

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引用次数: 0

Abstract

Background

Discharge (DC) to post-acute care facilities after head and neck cancer (HNC) surgery is common. Studies in various fields of medicine have shown that DC to facilities is associated with clinical outcomes. Evidence specific to HNC surgery is limited.

Objectives

This study aimed to evaluate how DC, to either home or a facility, impacts outcomes for patients undergoing HNC surgery.

Methods

Retrospective cohort study of patients who underwent HNC surgery between January 1, 2014, and January 1, 2023 was performed. Patients were included based on postoperative hospitalization, surgical interventions, and a minimum 30-day follow-up. The primary outcomes were 30-day readmission, 30-day mortality, and postoperative complication severity.

Results

Among 1,895 patients (mean age 63 years, 67% female), 1,554 (82%) were DC home and 341 (18%) to a facility. After adjusting for significant variables, DC site was not associated with readmission (OR 0.94, 95% CI 0.63–1.40), mortality (0.6% home vs 1.5% facility, p = 0.2), or complication severity (mild OR 1.3, p = 0.11; severe OR 1.0, p = 0.92). Factors such as dependency in activities of daily living, tracheotomy presence, surgery severity and prolonged hospitalization were found to be significant covariates in the multivariable analysis for both 30-day readmissions and complication severity. Facility patients had more infections or wound dehiscence (p < 0.05).

Conclusion

Although DC to a facility was not significantly associated with worsened outcomes in the multivariable analysis, the findings of this study revealed clinically relevant differences in complication rates and readmission.

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头颈癌手术后的出院位置是否影响预后质量？

背景：头颈癌（HNC）手术后出院（DC）是常见的急性后护理机构。各种医学领域的研究表明，对设施的DC与临床结果有关。针对HNC手术的证据有限。目的：本研究旨在评估DC对接受HNC手术的患者预后的影响，无论是家庭还是机构。方法：对2014年1月1日至2023年1月1日接受HNC手术的患者进行回顾性队列研究。纳入患者的基础是术后住院、手术干预和至少30天的随访。主要结局为30天再入院率、30天死亡率和术后并发症严重程度。结果：1895例患者（平均年龄63岁，67%为女性）中，1554例（82%）在DC家中，341例（18%）在医疗机构。在调整了重要变量后，DC部位与再入院（OR 0.94, 95% CI 0.63-1.40）、死亡率（0.6%家庭vs 1.5%医院，p = 0.2）或并发症严重程度（轻度OR 1.3, p = 0.11；重度OR 1.0, p = 0.92）无关。日常生活活动的依赖性、是否有气管切开术、手术严重程度和住院时间延长等因素在30天再入院和并发症严重程度的多变量分析中都被发现是重要的协变量。结论：尽管在多变量分析中，住院患者与预后恶化没有显著相关，但本研究的结果揭示了并发症发生率和再入院率的临床相关差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.