S Rothman1,2, S Zabarqa3,4, J Pitaro3,4, H Gavriel3,4, T Marom5, L Muallem Kalmovich3,4. 1. Department of Otolaryngology-Head and Neck Surgery, Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel. sarirothman@hotmail.com. 2. Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. sarirothman@hotmail.com. 3. Department of Otolaryngology-Head and Neck Surgery, Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel. 4. Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Department of Otolaryngology-Head and Neck Surgery, Faculty of Health Sciences, Assuta Ashdod University Hospital, Ben Gurion University of the Negev, Be'er Sheva, Israel.
Abstract
OBJECTIVES: To study whether any risk model, frailty index, patients' comorbidities, or demographic characteristics correlate with postoperative morbidity in elderly patients who underwent surgery for head and neck cancer (HNC). A secondary objective was to compare between frailty indexes that are used at our medical center. METHODS: A retrospective analysis of head and neck cancer patients operated between 2007 and 2021 was performed. RESULTS: One hundred and fifteen patients were included and divided into three age groups: 50-69 years, 70-79 years and ≥ 80 years. Although most elderly patients had a significantly higher rate of comorbidities and lower Norton scores, no statistically significant difference was found between the groups in postoperative morbidity rates, intensive care unit (ICU) or internal medicine department admissions, re-hospitalization in 1-3 months, and in falling risk (MFS-Morse Fall Scale). On multivariate analysis there was a positive correlation between preoperative cerebrovascular accident (CVA), dementia, and cardiac arrhythmias, and the probability for developing postoperative complication. The latter findings were not related to the patients' age. CONCLUSIONS: In this study, we did not find higher postoperative morbidity rates among elderly population in comparison to younger age groups, and therefore, our current evaluation system could not assist in identifying elderly at risk. However, prediction of operative risk based on physiologic reserve or frailty is an important tool in the evaluation of elderly head and neck cancer patients. Future studies are needed to assess the role of frailty index in the elderly head and neck cancer population.
OBJECTIVES: To study whether any risk model, frailty index, patients' comorbidities, or demographic characteristics correlate with postoperative morbidity in elderly patients who underwent surgery for head and neck cancer (HNC). A secondary objective was to compare between frailty indexes that are used at our medical center. METHODS: A retrospective analysis of head and neck cancer patients operated between 2007 and 2021 was performed. RESULTS: One hundred and fifteen patients were included and divided into three age groups: 50-69 years, 70-79 years and ≥ 80 years. Although most elderly patients had a significantly higher rate of comorbidities and lower Norton scores, no statistically significant difference was found between the groups in postoperative morbidity rates, intensive care unit (ICU) or internal medicine department admissions, re-hospitalization in 1-3 months, and in falling risk (MFS-Morse Fall Scale). On multivariate analysis there was a positive correlation between preoperative cerebrovascular accident (CVA), dementia, and cardiac arrhythmias, and the probability for developing postoperative complication. The latter findings were not related to the patients' age. CONCLUSIONS: In this study, we did not find higher postoperative morbidity rates among elderly population in comparison to younger age groups, and therefore, our current evaluation system could not assist in identifying elderly at risk. However, prediction of operative risk based on physiologic reserve or frailty is an important tool in the evaluation of elderly head and neck cancer patients. Future studies are needed to assess the role of frailty index in the elderly head and neck cancer population.