Patients who survive an episode of necrotizing fasciitis are at continued risk for premature death; many of these deaths were due to infectious causes such as pneumonia, cholecystitis, urinary tract infections, and sepsis. These patients should be counseled, followed, and immunized to minimize chances of death. Modification of other risk factors for death such as obesity, diabetes, smoking, and atherosclerotic disease should also be undertaken. The sex difference in long-term survival is intriguing and needs to be addressed in further studies.

Background This study is an evaluation of survival in patients with upper aerodigestive tract (UADT) cancer who did not receive guideline-directed therapy. Methods The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database was examined to identify patients with invasive cancer of the UADT. Patients were classified as “untreated” if they received neither surgery nor radiotherapy. Kaplan-Meier observed survival estimates were computed and stage-specific actuarial estimates of relative survival were computed. Results Of 3589 untreated patients, 13.7% were black, compared to 9.5% white, and 9.2% all other races (p < 0.0001). Patients with Stage IV disease were more likely to be untreated than those with Stage I disease (11.9% vs 3.8%, p < 0.0001). Median survival was 39 months for treated patients and 4 months for untreated patients. Conclusion The median survival for untreated patients was 4 months. Stage, race, and primary site were independently associated with untreated status.

Objective-The role of autopsy in evaluating missed injury after traumatic death is well established and discussed in the literature. The frequency of incidental findings in trauma patients has not been reported. We believe that incidental findings are under recognized and reported by trauma surgeons.Design-Prospective, descriptive, cohort study.Setting-Level 1 trauma center in a rural state.Patients-Four hundred ninety-six deaths over a 4-year period were identified from the trauma registry. Two hundred four complete autopsies were available for review.Interventions-One thousand eighteen traumatic diagnoses were identified from two hundred four autopsies and corresponding medical records by trauma surgeons blinded to patient identity. The surgeons recorded missed diagnoses, incidental diagnoses identified at autopsy, and diagnoses known at the time of death confirmed by autopsy.Measurements and Main Results-The surgeons had a kappa score of 0.82-0.84. Forty-two patients (21% of patients) had 68 severe missed injuries; sixty-seven patients (33% of patients) had 94 minor missed injuries. Twenty-eight patients (14%) had significant incidental findings including premature atherosclerosis, multiple endocrine neoplasia, tuberculosis, and others.Conclusions-The autopsy after traumatic death is more than a mechanism of quality control and teaching. A high proportion of patients will have incidental findings important to family members and have of public health importance. Systems need to be developed to review autopsy results with attention to identifying and communicating incidental findings. Given the incidence of significant missed injuries and incidental findings, the autopsy continues to have an important role in health care.

Background Survivorship is a critical part of head and neck cancer (HNC) care. In order to design better processes, we assessed care provided to long‐term HNC survivors and their priorities for ongoing care. Methods A survey was provided to HNC survivors at clinic appointments, including our HNC survivorship clinic. Questions focused on priorities for care in the otolaryngology clinic, types of care provided, and opioid use. Results Of 168 respondents, the most common priority for survivors was surveillance for recurrence (first priority in 75%), with general health the next most common (8%). Few respondents reported active primary care involvement in survivorship. About 10% of patients reported current opioid use. Conclusion Survivors face a large burden of symptoms and deficits, but our data show that most survivors focus on recurrence. Few survivors reported recall of survivorship care plan delivery or discussing cancer care needs with primary care providers.

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