Prevalence and Patient-Level Risk Factors for 30-Day Readmissions Following Free Tissue Transfer for Head and Neck Cancer

Abstract

In this study, advanced pathologic tumor staging and tumor location were associated with 30-day readmissions in patients with head and neck cancer who receive free flaps. Our results provide a benchmark for risk stratification that can be used in system-based practice improvements, health care cost savings, and postoperative patient counseling.

Outcomes of head and neck cancer surgery in the geriatric population based on case volume at academic centers

“…Due to the nature of the CDB/RM, readmissions to another hospital cannot be counted toward the index hospital readmission rate. Other studies report 30‐day readmission rates in the order of 3.2% to 14.5% . Despite this, the 7‐ and 30‐day readmission rates for geriatric patients (1.10%–1.75% and 3.84%–5.44%, respectively), when compared to previous studies for younger patients (1.55%–2.63% and 5.11%–6.76%, respectively) show that it is not that different.…”

Readmission following primary surgery for larynx and oropharynx cancer in the elderly

“…Dziegielewski et al also reported a 7.3% 30‐day readmission rate among all otolaryngology patients at their institution; however, when stratified by low‐ and high‐risk procedures, they found lower and higher 30‐day readmission rates, respectively. More complex procedures, such as head and neck oncologic surgery, are associated with a higher risk of 30‐day readmission . Unplanned 30‐day readmission rates following free tissue transfer can range from 7.9% to 11.6% .…”

The association between gastrostomy tube placement, poor post-operative outcomes, and hospital re-admissions in head and neck cancer patients

“…Our study is not the first study to evaluate risk factors for re-admission in head and neck cancer patients. In multiple studies, wound complications such as fistula or infection are among the most common reasons for readmission, with an estimate of 51% of re-admissions being related to complications [14,15,18]. Advanced tumor stage (T3-T4) as well as longer length of stay have also been found to be predictors re-admission [13,18].…”

“…In multiple studies, wound complications such as fistula or infection are among the most common reasons for readmission, with an estimate of 51% of re-admissions being related to complications [14,15,18]. Advanced tumor stage (T3-T4) as well as longer length of stay have also been found to be predictors re-admission [13,18]. Interestingly, the presence of a G-tube at discharge was found to have a 3-fold increase in the rate of re-admission, and was also found to predict re-admission for pneumonia [14].…”

“…Though pre-operative nutritional optimization may be protective against poor outcomes, our data also suggests that tumor characteristics in and of themselves can predict poor outcomes. Prior studies that found that advanced tumor stage predicts overall outcomes [13,18]. Further, prior studies have suggested that advanced tumors (T3-T4), and most consistently those of the hypopharynx, oral cavity and oropharynx are most likely to require G-tubes when treated with primary surgery or chemoradiation [3,21–23].…”