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 |
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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. |
doi_str_mv | 10.1007/s00405-022-07712-0 |
format | Article |
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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.</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 & 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. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-3226d845ff716591e242402a06c77b9cf9d69e06075b8e6456ee09213c0e32733</citedby><cites>FETCH-LOGICAL-c347t-3226d845ff716591e242402a06c77b9cf9d69e06075b8e6456ee09213c0e32733</cites><orcidid>0000-0003-4975-2513</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00405-022-07712-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00405-022-07712-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36269365$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rothman, S.</creatorcontrib><creatorcontrib>Zabarqa, S.</creatorcontrib><creatorcontrib>Pitaro, J.</creatorcontrib><creatorcontrib>Gavriel, H.</creatorcontrib><creatorcontrib>Marom, T.</creatorcontrib><creatorcontrib>Muallem Kalmovich, L.</creatorcontrib><title>Head and neck cancer surgery in elderly patients: the role of frailty assessment</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><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.</description><subject>Aged</subject><subject>Frailty - complications</subject><subject>Frailty - diagnosis</subject><subject>Frailty - epidemiology</subject><subject>Head and Neck</subject><subject>Head and Neck Neoplasms - complications</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Head and Neck Surgery</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neurosurgery</subject><subject>Otorhinolaryngology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - surgery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EoqXwBxiQR5bA-SN2zYYqvqRKMMBsuc4FUtKk2MmQf49LCiPL3XDP-0r3EHLO4IoB6OsIICHPgPMMtGZpHpApk0JmUnN1SKZghM6k1HpCTmJcA0AujTgmE6G4MkLlU_LyiK6grilog_6Tetd4DDT24R3DQKuGYl1gqAe6dV2FTRdvaPeBNLQ10rakZXBV3Q3UxYgxbhJwSo5KV0c82-8Zebu_e108Zsvnh6fF7TLzQuouE5yrYi7zstRM5YYhl1wCd6C81ivjS1Mog6BA56s5KpkrRDCcCQ8ouBZiRi7H3m1ov3qMnd1U0WNduwbbPlquuVYSNNuhfER9aGMMWNptqDYuDJaB3Zm0o0mbTNofkxZS6GLf3682WPxFftUlQIxATKcm6bLrtg9N-vm_2m9_R3zZ</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Rothman, S.</creator><creator>Zabarqa, S.</creator><creator>Pitaro, J.</creator><creator>Gavriel, H.</creator><creator>Marom, T.</creator><creator>Muallem Kalmovich, L.</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4975-2513</orcidid></search><sort><creationdate>20230301</creationdate><title>Head and neck cancer surgery in elderly patients: the role of frailty assessment</title><author>Rothman, S. ; Zabarqa, S. ; Pitaro, J. ; Gavriel, H. ; Marom, T. ; Muallem Kalmovich, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-3226d845ff716591e242402a06c77b9cf9d69e06075b8e6456ee09213c0e32733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Frailty - complications</topic><topic>Frailty - diagnosis</topic><topic>Frailty - epidemiology</topic><topic>Head and Neck</topic><topic>Head and Neck Neoplasms - complications</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Head and Neck Surgery</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neurosurgery</topic><topic>Otorhinolaryngology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - surgery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rothman, S.</creatorcontrib><creatorcontrib>Zabarqa, S.</creatorcontrib><creatorcontrib>Pitaro, J.</creatorcontrib><creatorcontrib>Gavriel, H.</creatorcontrib><creatorcontrib>Marom, T.</creatorcontrib><creatorcontrib>Muallem Kalmovich, L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rothman, S.</au><au>Zabarqa, S.</au><au>Pitaro, J.</au><au>Gavriel, H.</au><au>Marom, T.</au><au>Muallem Kalmovich, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Head and neck cancer surgery in elderly patients: the role of frailty assessment</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>280</volume><issue>3</issue><spage>1447</spage><epage>1453</epage><pages>1447-1453</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><abstract>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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36269365</pmid><doi>10.1007/s00405-022-07712-0</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4975-2513</orcidid></addata></record> |
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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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