BACKGROUND: Multiple factors have been identified as predictors of complication after head and neck surgery. However, little is known about the exact role of different comorbid conditions in the development of postoperative complications. This question is especially interesting in the elderly population. The aim of this study was to investigate the association between comorbidity and types of postoperative complications with special attention to age differences. METHODS: A retrospective analysis was performed of 1,201 major surgical interventions for head and neck malignancies in a tertiary referral center between 1995 and 2010. The Adult Comorbidity Evaluation 27 (ACE-27) index was used to analyze severity (mild, moderate, and severe comorbidity) and type (12 different organ systems) of comorbidity. The Clavien-Dindo index was used to evaluate grade and type of complications after treatment. RESULTS: In univariate analysis gender, comorbidity, stage, mandibulectomy, total laryngectomy, neck dissection, and length of surgery significantly predicted grade of complication. In a multivariate analysis, complication was predicted by age, stage, length of surgery, and various comorbidities. After specification of the complications, age was only a predictor of medical complications; tumor stage was a significant factor in surgical complications. Length of surgery was the only significant variable in all types of complications. CONCLUSIONS: Specific comorbidities are associated with specific complications; however, age itself seems not to be a contraindication for major head and neck surgery. With careful preoperative assessment and risk analysis, physicians can better individualize treatment recommendations.
BACKGROUND: Multiple factors have been identified as predictors of complication after head and neck surgery. However, little is known about the exact role of different comorbid conditions in the development of postoperative complications. This question is especially interesting in the elderly population. The aim of this study was to investigate the association between comorbidity and types of postoperative complications with special attention to age differences. METHODS: A retrospective analysis was performed of 1,201 major surgical interventions for head and neck malignancies in a tertiary referral center between 1995 and 2010. The Adult Comorbidity Evaluation 27 (ACE-27) index was used to analyze severity (mild, moderate, and severe comorbidity) and type (12 different organ systems) of comorbidity. The Clavien-Dindo index was used to evaluate grade and type of complications after treatment. RESULTS: In univariate analysis gender, comorbidity, stage, mandibulectomy, total laryngectomy, neck dissection, and length of surgery significantly predicted grade of complication. In a multivariate analysis, complication was predicted by age, stage, length of surgery, and various comorbidities. After specification of the complications, age was only a predictor of medical complications; tumor stage was a significant factor in surgical complications. Length of surgery was the only significant variable in all types of complications. CONCLUSIONS: Specific comorbidities are associated with specific complications; however, age itself seems not to be a contraindication for major head and neck surgery. With careful preoperative assessment and risk analysis, physicians can better individualize treatment recommendations.
Authors: R Montal; M Oliva; M Taberna; L De Avila; A Rovira; M Cos; M Mañós; V Navarro; J Nogués; A Lozano; L Rodríguez; E Vilajosana; S Vázquez; R Mesia Journal: Clin Transl Oncol Date: 2016-03-10 Impact factor: 3.405
Authors: Femke Jansen; Cornelia F van Uden-Kraan; Valesca van Zwieten; Birgit I Witte; Irma M Verdonck-de Leeuw Journal: Support Care Cancer Date: 2014-11-26 Impact factor: 3.603
Authors: Martine Froukje van der Kamp; Gyorgy Bela Halmos; Victor Guryev; Peter Laszlo Horvatovich; Ed Schuuring; Bernardus Franciscus Augustinus Maria van der Laan; Bert van der Vegt; Boudewijn Evert Christiaan Plaat; Cornelia Johanna Verhoeven Journal: Cell Oncol (Dordr) Date: 2022-01-11 Impact factor: 6.730
Authors: Thomas T A Peters; Sophie F Post; Boukje A C van Dijk; Jan L N Roodenburg; Bernard F A M van der Laan; Paul M N Werker; Gyorgy B Halmos Journal: Eur Arch Otorhinolaryngol Date: 2014-09-13 Impact factor: 2.503
Authors: Eeva Haapio; T Kiviniemi; H Irjala; P Koivunen; J K E Airaksinen; I Kinnunen Journal: Eur Arch Otorhinolaryngol Date: 2016-07-04 Impact factor: 2.503
Authors: A Hay; J Migliacci; D Karassawa Zanoni; J O Boyle; B Singh; R J Wong; S G Patel; I Ganly Journal: Clin Otolaryngol Date: 2017-12-26 Impact factor: 2.597