Disposition of Elderly Patients After Head and Neck Reconstruction

Abstract

Elderly patients are less likely to be discharged home after free flap reconstruction. Age, ASA score, and length of stay are independent factors for discharge to a nursing or other care facility.

Predictors and costs of readmissions at an academic head and neck surgery service

“…Graboyes et al also found LOS to be a dependent risk factor for 30dUR in otolaryngology patients. LOS ≥5 days likely represents a group of complex patients or with more comorbid conditions . Moreover, it reflects increased opportunity for hospital‐acquired complications, such as infections and deconditioning to occur …”

“…LOS 5 days likely represents a group of complex patients or with more comorbid conditions. [27][28][29] Moreover, it reflects increased opportunity for hospital-acquired complications, such as infections and deconditioning to occur. 29,30 G-tube presence at discharge predicted postoperative 30dUR (p 5 .01).…”

Head and neck cancer surgery in an elderly patient population: a retrospective review

“…oral cavity versus pharynx) or flap selection and hospital disposition. 20 Improvements in medical management, anaesthesia, and reconstructive surgery have allowed the successful treatment of elderly patients with head and neck cancers. Appropriate treatment should be based on individual patient desires and physical tolerance to surgery/treatment rather than based on age as the ultimate deciding factor.…”

Improving quality outcomes in head and neck free flap surgery with the use of a physician inpatient coordinator

“…However, head and neck cancer patients often carry multiple medical and social comorbidities, increasing their risk for suboptimal outcomes . They require complex coordination of care including tracheostomy and enteral feeding tube care, rehabilitation, discharge planning, and wound care …”

“…[8][9][10] They require complex coordination of care including tracheostomy and enteral feeding tube care, rehabilitation, discharge planning, and wound care. 3,11,12 Otolaryngology-head and neck surgery residency training programs function with rotating resident physicians. Residents are spread between inpatient care, outpatient clinics, and operating rooms.…”