Factors Predisposing to the Unplanned Hospital Readmission (UHR) in Patients Undergoing Surgery for Oral Cavity Squamous
- PDF / 251,240 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 78 Downloads / 195 Views
ORIGINAL ARTICLE
Factors Predisposing to the Unplanned Hospital Readmission (UHR) in Patients Undergoing Surgery for Oral Cavity Squamous Cell Carcinoma (OSCC): Experience from a Tertiary Cancer Centre Shivakumar Thiagarajan 1 & Shikhar Sawhney 1 & Siddhanth Jain 1 & Adhara Chakraborthy 1 & Nandini Menon 1 & Alaknanda Gupta 1 & Devendra Chaukar 1 Received: 14 April 2020 / Accepted: 8 June 2020 # Indian Association of Surgical Oncology 2020
Abstract Unplanned hospital readmissions (UHR) are known to add to patient morbidity, increase the cost of the treatment, and negatively impact the postoperative quality of life. The objective of the study was to identify the UHR rates of oral cavity squamous cell carcinoma (OSCC) patients following surgery and identify the predisposing factors for UHR. We conducted this retrospective analysis of all patients who underwent surgery for OSCC in our (single) surgical unit from January 2016 to December 2018. A total of 804 patients satisfied the eligibility criteria. Majority of the patients were males (n = 650, 80.8%). The median age of the patients was 50 years (Range: 16–89 years). The most common oral cavity subsite was buccal mucosa gingivobuccal (BM-GBS) OSCC. Forty patients (5%) required an UHR after discharge. The most common reason for readmissions was flap-related issues (11/40) and orocutaneous fistula (10/40). Other causes included wound infection (7/40), chest infection (2/40), hematoma/ bleeding (3/40), and other lesser prevalent causes (7/40). Factors that significantly predisposed patients for UHR were reexploration following the initial surgery [p < 0.001, OR 7.9 (4.09–15.59)] and BM-GBS subsite [< 0.001, OR: 2.89(1.24– 6.73)]. The UHR rate in our study was 5%. Patients requiring re-exploration following the initial surgery and those with BMGBS cancer were most likely to have the UHR. Keywords Oral cancer . Unplanned hospital readmission . Predisposing factors . Re-exploration . Oral cavity subsite
Introduction Oral cavity squamous cell carcinoma (OSCC) is a common type of cancer worldwide and the second most common cancer in India [1]. Surgery remains the primary treatment modality for OSCC, with or without adjuvant treatment. Surgery for cancer in general is associated with significant physical and mental stress to the patients enduring it [2]. Unplanned hospital readmissions (UHR) following surgery for cancer would only increase this stress, negatively impact the patient’s quality of life, delay the initiation of adjuvant therapy, and increase the chances of subsequent mortality [2]. UHR is
* Shivakumar Thiagarajan [email protected] 1
Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra 400012, India
defined as a subsequent unplanned admission within 30 days or 90 days after the initial treatment (i.e., surgery) [3, 4]. The rates of UHR following surgery for head and neck cancer reported in literature vary between 5.1–26.5% [5]. The costs associated with UHR are very high and it signific
Data Loading...
