Head and neck cancer surgery in elderly patients: the role of frailty assessment

Objectives To study whether any risk model, frailty index, patients' comorbidities, or demographic characteristics correlate with postoperative morbidity in elderly patients who underwent surgery for head and neck cancer (HNC). A secondary objective was to compare between frailty indexes that a...

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Veröffentlicht in:European archives of oto-rhino-laryngology 2023-03, Vol.280 (3), p.1447-1453
Hauptverfasser: Rothman, S., Zabarqa, S., Pitaro, J., Gavriel, H., Marom, T., Muallem Kalmovich, L.
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container_start_page 1447
container_title European archives of oto-rhino-laryngology
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creator Rothman, S.
Zabarqa, S.
Pitaro, J.
Gavriel, H.
Marom, T.
Muallem Kalmovich, L.
description Objectives To study whether any risk model, frailty index, patients' comorbidities, or demographic characteristics correlate with postoperative morbidity in elderly patients who underwent surgery for head and neck cancer (HNC). A secondary objective was to compare between frailty indexes that are used at our medical center. Methods A retrospective analysis of head and neck cancer patients operated between 2007 and 2021 was performed. Results One hundred and fifteen patients were included and divided into three age groups: 50–69 years, 70–79 years and ≥ 80 years. Although most elderly patients had a significantly higher rate of comorbidities and lower Norton scores, no statistically significant difference was found between the groups in postoperative morbidity rates, intensive care unit (ICU) or internal medicine department admissions, re-hospitalization in 1–3 months, and in falling risk (MFS—Morse Fall Scale). On multivariate analysis there was a positive correlation between preoperative cerebrovascular accident (CVA), dementia, and cardiac arrhythmias, and the probability for developing postoperative complication. The latter findings were not related to the patients' age. Conclusions In this study, we did not find higher postoperative morbidity rates among elderly population in comparison to younger age groups, and therefore, our current evaluation system could not assist in identifying elderly at risk. However, prediction of operative risk based on physiologic reserve or frailty is an important tool in the evaluation of elderly head and neck cancer patients. Future studies are needed to assess the role of frailty index in the elderly head and neck cancer population.
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A secondary objective was to compare between frailty indexes that are used at our medical center. Methods A retrospective analysis of head and neck cancer patients operated between 2007 and 2021 was performed. Results One hundred and fifteen patients were included and divided into three age groups: 50–69 years, 70–79 years and ≥ 80 years. Although most elderly patients had a significantly higher rate of comorbidities and lower Norton scores, no statistically significant difference was found between the groups in postoperative morbidity rates, intensive care unit (ICU) or internal medicine department admissions, re-hospitalization in 1–3 months, and in falling risk (MFS—Morse Fall Scale). On multivariate analysis there was a positive correlation between preoperative cerebrovascular accident (CVA), dementia, and cardiac arrhythmias, and the probability for developing postoperative complication. The latter findings were not related to the patients' age. Conclusions In this study, we did not find higher postoperative morbidity rates among elderly population in comparison to younger age groups, and therefore, our current evaluation system could not assist in identifying elderly at risk. However, prediction of operative risk based on physiologic reserve or frailty is an important tool in the evaluation of elderly head and neck cancer patients. Future studies are needed to assess the role of frailty index in the elderly head and neck cancer population.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-022-07712-0</identifier><identifier>PMID: 36269365</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Frailty - complications ; Frailty - diagnosis ; Frailty - epidemiology ; Head and Neck ; Head and Neck Neoplasms - complications ; Head and Neck Neoplasms - surgery ; Head and Neck Surgery ; Humans ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Multivariate Analysis ; Neurosurgery ; Otorhinolaryngology ; Postoperative Complications - epidemiology ; Postoperative Complications - surgery ; Retrospective Studies ; Risk Factors</subject><ispartof>European archives of oto-rhino-laryngology, 2023-03, Vol.280 (3), p.1447-1453</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. 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A secondary objective was to compare between frailty indexes that are used at our medical center. Methods A retrospective analysis of head and neck cancer patients operated between 2007 and 2021 was performed. Results One hundred and fifteen patients were included and divided into three age groups: 50–69 years, 70–79 years and ≥ 80 years. Although most elderly patients had a significantly higher rate of comorbidities and lower Norton scores, no statistically significant difference was found between the groups in postoperative morbidity rates, intensive care unit (ICU) or internal medicine department admissions, re-hospitalization in 1–3 months, and in falling risk (MFS—Morse Fall Scale). On multivariate analysis there was a positive correlation between preoperative cerebrovascular accident (CVA), dementia, and cardiac arrhythmias, and the probability for developing postoperative complication. The latter findings were not related to the patients' age. Conclusions In this study, we did not find higher postoperative morbidity rates among elderly population in comparison to younger age groups, and therefore, our current evaluation system could not assist in identifying elderly at risk. However, prediction of operative risk based on physiologic reserve or frailty is an important tool in the evaluation of elderly head and neck cancer patients. 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subjects Aged
Frailty - complications
Frailty - diagnosis
Frailty - epidemiology
Head and Neck
Head and Neck Neoplasms - complications
Head and Neck Neoplasms - surgery
Head and Neck Surgery
Humans
Medicine
Medicine & Public Health
Middle Aged
Multivariate Analysis
Neurosurgery
Otorhinolaryngology
Postoperative Complications - epidemiology
Postoperative Complications - surgery
Retrospective Studies
Risk Factors
title Head and neck cancer surgery in elderly patients: the role of frailty assessment
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