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Celeste N. Powers - One of the best experts on this subject based on the ideXlab platform.
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accuracy utility and cost of frozen section margins in head and Neck Cancer Surgery
Laryngoscope, 2000Co-Authors: Laurence J. Dinardo, James Lin, Lampros S. Karageorge, Celeste N. PowersAbstract:Objectives Intraoperative frozen section analysis of surgical margins is widely used in head and Neck Cancer Surgery. This study evaluates frozen section accuracy relative to permanent controls and final margins from the entire specimen, the rate at which frozen sections impact intraoperative management, and the resultant cost. Study Design Retrospective. Methods From 1997 to 1999 the frozen section results, permanent controls, and final tumor margins from 80 consecutive patients undergoing 420 intraoperative frozen section margins for head and Neck malignancy were reviewed. Results A 98.3% accuracy rate (sensitivity, 88.8%; specificity, 98.9%) was found compared with permanent sections of the same tissue. However, 40% (8 of 20) of patients with positive final margins on the resection specimen, and 100% (15 of 15) with close (<5 mm) margins were not detected by frozen section analysis. The overall accuracy of frozen section in the evaluation of close or positive final margins was 71.3% (sensitivity, 34.3%; specificity, 100%). In addition, 5% (4 of 80) of patients potentially benefited from intraoperative frozen section by virtue of immediate margin revision. The estimated cost of intraoperative frozen section averaged as much as $3123 per patient, with a cost-benefit ratio of 20:1. Conclusions Intraoperative frozen section margins are accurate, but they are costly and cannot reliably eradicate positive final margins. Patients with early-stage lesions and those undergoing re-resection for recurrence or salvage Surgery after radiation failure derived the greatest potential benefit from frozen section margins.
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Accuracy, utility, and cost of frozen section margins in head and Neck Cancer Surgery.
The Laryngoscope, 2000Co-Authors: Laurence J. Dinardo, James Lin, Lampros S. Karageorge, Celeste N. PowersAbstract:Objectives Intraoperative frozen section analysis of surgical margins is widely used in head and Neck Cancer Surgery. This study evaluates frozen section accuracy relative to permanent controls and final margins from the entire specimen, the rate at which frozen sections impact intraoperative management, and the resultant cost. Study Design Retrospective. Methods From 1997 to 1999 the frozen section results, permanent controls, and final tumor margins from 80 consecutive patients undergoing 420 intraoperative frozen section margins for head and Neck malignancy were reviewed. Results A 98.3% accuracy rate (sensitivity, 88.8%; specificity, 98.9%) was found compared with permanent sections of the same tissue. However, 40% (8 of 20) of patients with positive final margins on the resection specimen, and 100% (15 of 15) with close (
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Accuracy, utility, and cost of frozen section margins in head and Neck Cancer Surgery.
The Laryngoscope, 2000Co-Authors: Laurence J. Dinardo, James Lin, Lampros S. Karageorge, Celeste N. PowersAbstract:Intraoperative frozen section analysis of surgical margins is widely used in head and Neck Cancer Surgery. This study evaluates frozen section accuracy relative to permanent controls and final margins from the entire specimen, the rate at which frozen sections impact intraoperative management, and the resultant cost. Retrospective. From 1997 to 1999 the frozen section results, permanent controls, and final tumor margins from 80 consecutive patients undergoing 420 intraoperative frozen section margins for head and Neck malignancy were reviewed. A 98.3% accuracy rate (sensitivity, 88.8%; specificity, 98.9%) was found compared with permanent sections of the same tissue. However, 40% (8 of 20) of patients with positive final margins on the resection specimen, and 100% (15 of 15) with close (<5 mm) margins were not detected by frozen section analysis. The overall accuracy of frozen section in the evaluation of close or positive final margins was 71.3% (sensitivity, 34.3%; specificity, 100%). In addition, 5% (4 of 80) of patients potentially benefited from intraoperative frozen section by virtue of immediate margin revision. The estimated cost of intraoperative frozen section averaged as much as $3,123 per patient, with a cost-benefit ratio of 20:1. Intraoperative frozen section margins are accurate, but they are costly and cannot reliably eradicate positive final margins. Patients with early-stage lesions and those undergoing re-resection for recurrence or salvage Surgery after radiation failure derived the greatest potential benefit from frozen section margins.
Jean-louis Lefebvre - One of the best experts on this subject based on the ideXlab platform.
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Head and Neck Cancer Surgery in the elderly--does age influence the postoperative course?
Oral oncology, 2009Co-Authors: Pedro Ricardo Milet, Nicolas Penel, Yann Mallet, Sophie El Bedoui, Véronique Servent, Jean-louis LefebvreAbstract:Summary There are few data focusing on postoperative course after major head and Neck Cancer Surgery in the elderly compared with the younger population. The aim of this study was to assess the impact of age on postoperative outcomes. At hospital admission, we prospectively collected data from 261 patients separated into two groups with regard to their age (those ⩾70 years and those The impact of age on postoperative deaths was assessed after adjustment for potential risk factors. In a logistic regression model, postoperative death risk remained insignificantly increased in the elderly (adjusted Odds Ratio = 3.3 [0.7–14.9], p = 0.22). In our experience, the postoperative course in elderly patients is not significantly different from that than in younger patients.
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Factors determining length of the postoperative hospital stay after major head and Neck Cancer Surgery
Oral oncology, 2007Co-Authors: Nicolas Penel, Micheline Roussel-delvallez, Yann Mallet, Jean-louis Lefebvre, Yazdan YazdanpanahAbstract:Summary Hospital stays constitute the main component of costs of Cancer treatment. We conducted a prospective study to identify the determinants of the length of stay (LOS) after head and Neck Cancer Surgery (HNCS). Patients who underwent major HNCS with opening of mucosa and with curative intent were enrolled. Data were collected for patient characteristics, type of tumour, surgical procedures and postoperative outcome. LOS defined as the interval between the day of admission for Surgery until hospital discharge or death was determined by the Kaplan–Meier method. Independent determinants of LOS were identified using a Cox model. All 260 patients were included. Median LOS was 26 days (range, 3–178). In the multivariate model, four variables remained associated with increased LOS: American Society of Anaesthesiologist’s score equal to 3 (hazard ratio 1.62 [1.23–1.99]), duration of surgical procedure >220 min., (HR = 1.37 [1.22–1.56]), SSI (HR = 2.09 [2.02–2.54]), occurrence of SSI caused by multi-resistant pathogen (HR = 2.92 [2.78–3.77]) and occurrence of PP (HR = 2.09 [1.78–2.81]). The present results highlighted the long duration of LOS after head and Neck Cancer Surgery. Two variables (duration of surgical procedure and occurrence of nosocomial infections) were associated with LOS and might be improved by appropriate strategies.
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A simple predictive model for postoperative mortality after head and Neck Cancer Surgery with opening of mucosa.
Oral oncology, 2006Co-Authors: Nicolas Penel, Stéphanie Clisant, Danièle Lefebvre, Ahmed Kara, Yann Mallet, Jean-charles Neu, Eric Amela, Frédéric Everard, Jean-louis LefebvreAbstract:Summary The aim of this study was to determine the risk factors for the mortality during the first 30 days after a major head and Neck Cancer Surgery. Two hundred and sixty one consecutive surgical procedure were prospectively studied at Oscar Lambret Cancer Centre within a 36-months period. Twenty variables were recorded for each patient. The significant risk factors for postoperative mortality were assessed by univariate and multivariate analysis. Overall 30-days mortality rate was 3.83% [95% CI 3.13–4.53]. In univariate analysis identified four risk factors: female gender (odd ratio 4.25 [95% CI 1.03–17.56]), age equal or superior than 70 (odd ratio 5.06 [95% CI 1.35–18.36]), current alcohol addiction (odd ratio 3.65 [1.02–13.06]) and laryngeal location (odd ratio 4.23 [CI 95% 1.18–3.38]). In multivariate analysis only female gender and laryngeal location remained significant. The incidence of postoperative mortality was 1.63% for patients without risk factor and was 6.41% for those with one or two risk factors. This model identifies easily high-risk patients for major head and Neck Cancer Surgery. A multicenter validation is necessary.
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Prognostic significance of wound infections following major head and Neck Cancer Surgery: an open non-comparative prospective study.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2004Co-Authors: Nicolas Penel, C. Fournier, Micheline Roussel-delvallez, Danièle Lefebvre, Ahmed Kara, Yann Mallet, Jean-charles Neu, Jean-louis LefebvreAbstract:Objective We evaluated the incidence, risk factors and consequences of wound infection (WI) following major head and Neck Cancer Surgery in an open non-comparative study.
Laurence J. Dinardo - One of the best experts on this subject based on the ideXlab platform.
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accuracy utility and cost of frozen section margins in head and Neck Cancer Surgery
Laryngoscope, 2000Co-Authors: Laurence J. Dinardo, James Lin, Lampros S. Karageorge, Celeste N. PowersAbstract:Objectives Intraoperative frozen section analysis of surgical margins is widely used in head and Neck Cancer Surgery. This study evaluates frozen section accuracy relative to permanent controls and final margins from the entire specimen, the rate at which frozen sections impact intraoperative management, and the resultant cost. Study Design Retrospective. Methods From 1997 to 1999 the frozen section results, permanent controls, and final tumor margins from 80 consecutive patients undergoing 420 intraoperative frozen section margins for head and Neck malignancy were reviewed. Results A 98.3% accuracy rate (sensitivity, 88.8%; specificity, 98.9%) was found compared with permanent sections of the same tissue. However, 40% (8 of 20) of patients with positive final margins on the resection specimen, and 100% (15 of 15) with close (<5 mm) margins were not detected by frozen section analysis. The overall accuracy of frozen section in the evaluation of close or positive final margins was 71.3% (sensitivity, 34.3%; specificity, 100%). In addition, 5% (4 of 80) of patients potentially benefited from intraoperative frozen section by virtue of immediate margin revision. The estimated cost of intraoperative frozen section averaged as much as $3123 per patient, with a cost-benefit ratio of 20:1. Conclusions Intraoperative frozen section margins are accurate, but they are costly and cannot reliably eradicate positive final margins. Patients with early-stage lesions and those undergoing re-resection for recurrence or salvage Surgery after radiation failure derived the greatest potential benefit from frozen section margins.
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Accuracy, utility, and cost of frozen section margins in head and Neck Cancer Surgery.
The Laryngoscope, 2000Co-Authors: Laurence J. Dinardo, James Lin, Lampros S. Karageorge, Celeste N. PowersAbstract:Objectives Intraoperative frozen section analysis of surgical margins is widely used in head and Neck Cancer Surgery. This study evaluates frozen section accuracy relative to permanent controls and final margins from the entire specimen, the rate at which frozen sections impact intraoperative management, and the resultant cost. Study Design Retrospective. Methods From 1997 to 1999 the frozen section results, permanent controls, and final tumor margins from 80 consecutive patients undergoing 420 intraoperative frozen section margins for head and Neck malignancy were reviewed. Results A 98.3% accuracy rate (sensitivity, 88.8%; specificity, 98.9%) was found compared with permanent sections of the same tissue. However, 40% (8 of 20) of patients with positive final margins on the resection specimen, and 100% (15 of 15) with close (
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Accuracy, utility, and cost of frozen section margins in head and Neck Cancer Surgery.
The Laryngoscope, 2000Co-Authors: Laurence J. Dinardo, James Lin, Lampros S. Karageorge, Celeste N. PowersAbstract:Intraoperative frozen section analysis of surgical margins is widely used in head and Neck Cancer Surgery. This study evaluates frozen section accuracy relative to permanent controls and final margins from the entire specimen, the rate at which frozen sections impact intraoperative management, and the resultant cost. Retrospective. From 1997 to 1999 the frozen section results, permanent controls, and final tumor margins from 80 consecutive patients undergoing 420 intraoperative frozen section margins for head and Neck malignancy were reviewed. A 98.3% accuracy rate (sensitivity, 88.8%; specificity, 98.9%) was found compared with permanent sections of the same tissue. However, 40% (8 of 20) of patients with positive final margins on the resection specimen, and 100% (15 of 15) with close (<5 mm) margins were not detected by frozen section analysis. The overall accuracy of frozen section in the evaluation of close or positive final margins was 71.3% (sensitivity, 34.3%; specificity, 100%). In addition, 5% (4 of 80) of patients potentially benefited from intraoperative frozen section by virtue of immediate margin revision. The estimated cost of intraoperative frozen section averaged as much as $3,123 per patient, with a cost-benefit ratio of 20:1. Intraoperative frozen section margins are accurate, but they are costly and cannot reliably eradicate positive final margins. Patients with early-stage lesions and those undergoing re-resection for recurrence or salvage Surgery after radiation failure derived the greatest potential benefit from frozen section margins.
Christine G. Gourin - One of the best experts on this subject based on the ideXlab platform.
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Temporal trends in head and Neck Cancer Surgery reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2014Co-Authors: Zhen Gooi, Christine G. Gourin, Kofi D. O. Boahene, Patrick J. Byrne, Jeremy D. RichmonAbstract:Background The purpose of this study was to analyze changing trends in head and Neck Cancer reconstructive Surgery and analyze the effect of surgeon and hospital volume. Methods Data from the Nationwide Inpatient Sample (NIS) for 133,850 patients who underwent a major ablative procedure for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 1993 to 2010 were analyzed using cross-tabulations and multivariate regression. Results Reconstructive Surgery in 2001 to 2010 was significantly associated with prior radiation (odds ratio [OR] = 2.6; 95% confidence interval [95% CI] = 1.4–4.9), comorbidity (OR = 1.6; 95% CI = 1.1–2.2), laryngeal Cancer (OR = 0.7; 95% CI = 0.6–0.9), oropharyngeal Cancer (OR = 0.5; 95% CI = 0.4–0.7), high-volume hospitals (OR = 3.9; 95% CI = 1.5–10.2), and high-volume surgeons (OR = 2.0; 95% CI = 1.1–3.9), compared to 1993–2000. Reconstruction by high-volume surgeons was significantly associated with prior radiation (OR = 1.8; 95% CI = 1.1–3.1) and lower in-hospital mortality (OR = 0.3; 95% CI = 0.1–1.0). A statistically significant negative correlation was observed between high-volume surgeons and length of hospitalization and hospital-related costs. Conclusion These data reflect changing trends in head and Neck Cancer reconstructive Surgery, with meaningful differences in the type of surgical care provided by high-volume surgeons. © 2014 Wiley Periodicals, Inc. Head Neck, 2014
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Effect of comorbidity on short-term outcomes and cost of care after head and Neck Cancer Surgery in the elderly
Head & neck, 2014Co-Authors: Dane J. Genther, Christine G. GourinAbstract:Background With increased life expectancy, there is growing awareness of the effect of comorbidity on physiologic reserves in elderly patients. Data in the area of head and Neck Cancer Surgery is lacking. Methods Retrospective data from 61,740 elderly patients who underwent a head and Neck Cancer ablative Surgery from 2001 to 2010 using the Nationwide Inpatient Sample were analyzed to examine associations between comorbidity and in-hospital mortality, postoperative complications, length of hospitalization, and hospital-related costs. Results Advanced comorbidity was present in 18% of elderly patients, who were more likely to experience acute medical complications (odds ratio [OR], 3.7; p < .001), in-hospital death (OR, 3.6; p < .001), increased length of hospitalization (mean, 2.2 days; p < .001), and hospital-related costs (mean, $6874; p < .001). Conclusion Advanced comorbidity in elderly surgical patients with head and Neck Cancer is associated with increased mortality, morbidity, length of hospitalization, and hospital-related costs. This increased utilization of health care resources may pose challenges to health care reform efforts as the population ages. © 2014 Wiley Periodicals, Inc. Head Neck 37: 685–693, 2015
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hospital acquired conditions in head and Neck Cancer Surgery
Laryngoscope, 2013Co-Authors: Amit Kochhar, Peter J Pronovost, Christine G. GourinAbstract:Objectives/Hypothesis The Centers for Medicare and Medicaid Services has identified 10 hospital-acquired conditions (HACs) for which they will not reimburse care. We sought to determine the incidence of HACs in head and Neck Cancer (HNCA) Surgery and the association with in-hospital mortality, complications, length of hospitalization, and costs. Study Design Retrospective cross-sectional study. Methods Discharge data from the Nationwide Inpatient Sample for 123,662 patients who underwent an ablative procedure for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm during 2001–2008 were analyzed using cross-tabulations and multivariate regression modeling. Results HACs occurred in 70% of all HACs. The occurrence of HACs was significantly associated with urgent or emergent admission (odds ratio [OR]=2.0, P=.004), major surgical procedures (OR=2.3, P<.001), flap reconstruction (OR=3.5, P<.001), and advanced comorbidity (OR=2.0, P<.001). There was no association between HACs and hospital size, location, ownership, volume status, or safety-net burden. HACs were significantly associated with in-hospital mortality (OR=3.8, P=.001), surgical complications (OR=4.9, P<.001), and medical complications (OR=5.6, P<.001). After controlling for all other variables, HACs were associated with significantly increased length of hospitalization and hospital-related costs, with vascular catheter-associated infection and foreign object after Surgery associated with the greatest increase in length of stay and costs. Conclusions HACs are uncommon events in HNCA surgical patients. Because prediction of HACs is poor and the potential for human error crosses demographic, geographic, and structural boundaries, universal innovative measures to reduce the occurrence of HACs are needed. Level of Evidence 2c. Laryngoscope, 2013
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The Effect of Hospital Safety-Net Burden Status on Short-term Outcomes and Cost of Care After Head and Neck Cancer Surgery
Archives of otolaryngology--head & neck surgery, 2012Co-Authors: Dane J. Genther, Christine G. GourinAbstract:Objective To determine the association between safety-net hospital care and short-term outcomes after head and Neck Cancer Surgery. Design Cross-sectional analysis. Safety-net burden was calculated as the percentage of patients with head and Neck Cancer with Medicaid or no insurance. Setting Nationwide Inpatient Sample database. Patients Adults who underwent an ablative procedure for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 through 2008. Main Outcome Measures Associations between hospital safety-net burden and short-term morality, medical and surgical complications, length of hospitalization, and costs. Results Overall, 123 662 patients underwent Surgery in 2001 through 2008. Patients treated at high–safety-net burden hospitals were significantly more likely to be admitted urgently or emergently (odds ratio [OR], 1.54; 95% CI, 1.06-2.25 [P = .03]), undergo major surgical procedures (OR, 1.24; 95% CI, 1.09-1.39 [P = .001]), have advanced comorbidity (OR, 1.35; 95% CI, 1.06-1.72 [P = .02]), and be black (OR, 1.70; 95% CI, 1.29-2.23 [P Conclusions These data suggest that safety-net hospitals provide valuable specialty care to a vulnerable population without an increase in complications or costs. Health care reform must address the economic challenges that threaten the viability of these institutions at the same time that demand for their services increases.
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Head and Neck Cancer Surgery in the Elderly
Otolaryngology–Head and Neck Surgery, 2012Co-Authors: Dane J. Genther, Christine G. GourinAbstract:Objective: With increased life expectancy, there is a growing awareness of the effect of comorbidity on physiologic reserves in elderly surgical patients. We sought to determine the relationship between advanced comorbidity on in-hospital mortality, postoperative complications, length of hospitalization, and costs in elderly patients undergoing head and Neck Cancer (HNCA) Surgery.Method: Discharge data from the Nationwide Inpatient Sample for 36,948 patients aged 65 years and older who underwent ablative Surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2003 to 2008 were analyzed using cross-tabulations and multivariate regression. Frail elderly patients were defined as having comorbidity scores of 2 or higher.Results: Frail elderly patients were more likely to be ≥80 years of age (OR 1.2, P = .035) and more likely to require transfer to a short-term hospital (OR = 3.7, P < .001), transfer to another facility (OR = 2.5, P < .001), or home health care (OR = 1.4, P...
Nicolas Penel - One of the best experts on this subject based on the ideXlab platform.
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Head and Neck Cancer Surgery in the elderly--does age influence the postoperative course?
Oral oncology, 2009Co-Authors: Pedro Ricardo Milet, Nicolas Penel, Yann Mallet, Sophie El Bedoui, Véronique Servent, Jean-louis LefebvreAbstract:Summary There are few data focusing on postoperative course after major head and Neck Cancer Surgery in the elderly compared with the younger population. The aim of this study was to assess the impact of age on postoperative outcomes. At hospital admission, we prospectively collected data from 261 patients separated into two groups with regard to their age (those ⩾70 years and those The impact of age on postoperative deaths was assessed after adjustment for potential risk factors. In a logistic regression model, postoperative death risk remained insignificantly increased in the elderly (adjusted Odds Ratio = 3.3 [0.7–14.9], p = 0.22). In our experience, the postoperative course in elderly patients is not significantly different from that than in younger patients.
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Additional direct medical costs associated with nosocomial infections after head and Neck a Cancer Surgery: a hospital-perspective analysis
International Journal of Oral and Maxillofacial Surgery, 2008Co-Authors: Nicolas Penel, J C Neu, Stéphanie Clisant, J-l Cazin, J. L. Lefebvre, Benoit Dervaux, Yazdan YazdanpanahAbstract:The clinical impact of surgical site infections (SSI) and postoperative pneumonia (PP) after head and Neck Cancer Surgery has been assessed in the past, but little is known about their economic impact. The present study was designed to evaluate costs related to SSI and PP after head and Neck Cancer Surgery with opening of mucosa. The incidence of SSI and PP was measured in a prospective cohort of 261 patients who had undergone head and Neck Cancer Surgery. The additional direct medical costs related to these infections from the hospital perspective were determined based on postoperative length of stay. The mean direct hospital costs for patients with and without SSI or PP were compared. Of the 261 patients, 81 (31%), 21 (8%) and 13 (5%) developed SSI, PP or both, respectively. The additional lengths of stay attributable to SSI, PP or both were 16, 17 and 31 days, respectively, and additional direct medical costs related to these conditions were 17,000, 19,000 and 35,000 Euros. Nosocomial infections after head and Neck Cancer Surgery significantly increase patients' length of stay and therefore generate additional direct medical costs. These results support the application of preventive interventions to reduce nosocomial infections in this setting.
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Factors determining length of the postoperative hospital stay after major head and Neck Cancer Surgery
Oral oncology, 2007Co-Authors: Nicolas Penel, Micheline Roussel-delvallez, Yann Mallet, Jean-louis Lefebvre, Yazdan YazdanpanahAbstract:Summary Hospital stays constitute the main component of costs of Cancer treatment. We conducted a prospective study to identify the determinants of the length of stay (LOS) after head and Neck Cancer Surgery (HNCS). Patients who underwent major HNCS with opening of mucosa and with curative intent were enrolled. Data were collected for patient characteristics, type of tumour, surgical procedures and postoperative outcome. LOS defined as the interval between the day of admission for Surgery until hospital discharge or death was determined by the Kaplan–Meier method. Independent determinants of LOS were identified using a Cox model. All 260 patients were included. Median LOS was 26 days (range, 3–178). In the multivariate model, four variables remained associated with increased LOS: American Society of Anaesthesiologist’s score equal to 3 (hazard ratio 1.62 [1.23–1.99]), duration of surgical procedure >220 min., (HR = 1.37 [1.22–1.56]), SSI (HR = 2.09 [2.02–2.54]), occurrence of SSI caused by multi-resistant pathogen (HR = 2.92 [2.78–3.77]) and occurrence of PP (HR = 2.09 [1.78–2.81]). The present results highlighted the long duration of LOS after head and Neck Cancer Surgery. Two variables (duration of surgical procedure and occurrence of nosocomial infections) were associated with LOS and might be improved by appropriate strategies.
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A simple predictive model for postoperative mortality after head and Neck Cancer Surgery with opening of mucosa.
Oral oncology, 2006Co-Authors: Nicolas Penel, Stéphanie Clisant, Danièle Lefebvre, Ahmed Kara, Yann Mallet, Jean-charles Neu, Eric Amela, Frédéric Everard, Jean-louis LefebvreAbstract:Summary The aim of this study was to determine the risk factors for the mortality during the first 30 days after a major head and Neck Cancer Surgery. Two hundred and sixty one consecutive surgical procedure were prospectively studied at Oscar Lambret Cancer Centre within a 36-months period. Twenty variables were recorded for each patient. The significant risk factors for postoperative mortality were assessed by univariate and multivariate analysis. Overall 30-days mortality rate was 3.83% [95% CI 3.13–4.53]. In univariate analysis identified four risk factors: female gender (odd ratio 4.25 [95% CI 1.03–17.56]), age equal or superior than 70 (odd ratio 5.06 [95% CI 1.35–18.36]), current alcohol addiction (odd ratio 3.65 [1.02–13.06]) and laryngeal location (odd ratio 4.23 [CI 95% 1.18–3.38]). In multivariate analysis only female gender and laryngeal location remained significant. The incidence of postoperative mortality was 1.63% for patients without risk factor and was 6.41% for those with one or two risk factors. This model identifies easily high-risk patients for major head and Neck Cancer Surgery. A multicenter validation is necessary.
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Prognostic significance of wound infections following major head and Neck Cancer Surgery: an open non-comparative prospective study.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2004Co-Authors: Nicolas Penel, C. Fournier, Micheline Roussel-delvallez, Danièle Lefebvre, Ahmed Kara, Yann Mallet, Jean-charles Neu, Jean-louis LefebvreAbstract:Objective We evaluated the incidence, risk factors and consequences of wound infection (WI) following major head and Neck Cancer Surgery in an open non-comparative study.
