30-day Readmission After Parotid Cancer Surgery Linked to Increased 30-day Mortality Risk

Having an unplanned readmission within 30 days of undergoing definitive surgery is associated with increased risk of 30-day mortality among patients with previously untreated parotid cancer, a study published in JAMA Otolaryngology–Head & Neck Surgery has shown.1

Because 30-day unplanned readmissions are becoming increasingly used as a measure of quality care, researchers sought to characterize the incidence of and risk factors for 30-day unplanned readmissions for patients undergoing treatment for cancer of the parotid gland, a type of head and neck cancer.

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For the retrospective cohort study, researchers analyzed data from 11 394 previously untreated patients with parotid cancer who underwent definitive surgery from the National Cancer Database. Patients were treated between 2003 and 2012.

Results showed that the 30-day unplanned readmission rate following parotidectomy was 2.1%. Researchers found that advanced pathologic T category (OR, 1.59; 95% CI, 1.14-2.20), uninsured status (OR, 2.27; 95% CI, 1.07-4.80), and increased comorbidity as measured by the Charlson/Deyo Score (CDS) were associated with increased risk for 30-day unplanned readmission.

“Thirty-day unplanned readmissions following surgery for parotid cancers are uncommon and linked to comorbidity, insurance, and oncologic characteristics,” the researchers reported.

The study further demonstrated that a 30-day unplanned readmission was associated with an 8.4-fold (OR, 8.36; 95% CI, 2.04-34.40) increased risk of 30-day mortality.

Patients who were admitted for 7 or more days, those with distant metastases, patients with a CDS greater than 1, and those age 80 years or older also had higher rates of 30-day mortality.

REFERENCE

1. Zhan KY, Graboyes EM, Ngugen SA, Day TA, et al. Risk factors associated with unplanned readmission in patients undergoing parotid cancer surgery [published online ahead of print April 14, 2016]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2016.0216.

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