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Factors Affecting In-Hospital Mortality Among Patients With Head and Neck Cancer

By: Cordi Craig
Posted: Wednesday, May 13, 2020

A cross-sectional study, published in JAMA Otolaryngology–Head & Neck Surgery, reported that both patient- and hospital-level factors were associated with in-hospital mortalities among patients with head and neck cancer. Eric Adjei Boakye, PhD, of Southern Illinois University, Springfield, and colleagues developed a nomogram intended for use as a clinical instrument to identify patients at higher risk. These findings may improve patient hospitalization experiences and courses of action.

Using the 2008 to 2013 National Inpatient Sample database, the research team built a hospital mortality prediction model, presented as a nomogram, to evaluate in-hospital mortality among patients older than age 18 who were diagnosed with head and neck cancer. The investigators identified 85,440 patients.

Overall, 3,610 patients (4.2%) died in the hospital. The researchers identified several patient-level and hospital-level factors that were associated with an increased risk of in-hospital death. The patient-level factors included older age (adjusted odds ratio [OR] = 1.03 per 1-year increase), male sex (adjusted OR = 1.23), higher number of comorbidities (adjusted OR = 1.14), having metastatic cancer (adjusted OR = 1.49), nonelective admission (adjusted OR = 3.26), and being admitted to the hospital on a weekend (adjusted OR = 1.30). Admission to a nonteaching institution (adjusted OR = 1.48) was the most significant hospital-level factor associated with in-hospital mortality. The researchers noted that teaching hospitals tended to have a high volume of admissions and perform more ablative and reconstructive surgeries than nonteaching and community centers, which are more likely to treat head and neck cancer with radiation and without chemotherapy.

“These multilevel factors are critical indicators of survivorship and should thus be considered when planning programs or interventions aimed to improve survival among this unique population,” the researchers noted.

Disclosure: The study authors reported no conflicts of interest.

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