Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample
Abstract Background Frailty is linked to perioperative morbidity and mortality. We evaluated the impact of preoperative frailty on inpatient outcomes of patients undergoing surgery for thyroid malignancy. Methods This population-based, retrospective observational study extracted data of hospitalized...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-07-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40463-020-00450-5 |
| _version_ | 1826910273076723712 |
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| author | Dong Xu Mengjia Fei Yi Lai Yuling Shen Jiaqing Zhou |
| author_facet | Dong Xu Mengjia Fei Yi Lai Yuling Shen Jiaqing Zhou |
| author_sort | Dong Xu |
| collection | DOAJ |
| description | Abstract Background Frailty is linked to perioperative morbidity and mortality. We evaluated the impact of preoperative frailty on inpatient outcomes of patients undergoing surgery for thyroid malignancy. Methods This population-based, retrospective observational study extracted data of hospitalized patients who were 18 years and older with a primary diagnosis of thyroid cancer undergoing thyroidectomy from the US Nationwide Inpatient Sample (NIS) database (2005–2014). Participants were stratified into frail and non-frail using the Johns Hopkins (ACG) frailty-defining diagnosis indicator. Study endpoints were in-hospital mortality, incidence of surgical and medical complications and prolonged length of stay. Univariate and multivariate analysis were performed to determine associations between the endpoints and frailty. Results Data of 38,202 patients were included. After adjusting for possible confounders, frailty remained significantly associated with higher odds of in-hospital mortality (OR: 3.839, 95% CI: 1.738–8.480), prolonged length of stay (OR: 5.420, 95% CI: 3.799–7.733), surgical complications (OR: 3.144, 95% CI: 2.443–4.045) and medical complications (OR: 6.734, 95% CI: 5.099–8.893) compared with non-frailty. In patients > age 65 years, adjusted odds ratio for frailty was 4.099 (95% CI: 1.736–9.679) for in-hospital mortality, 6.164 (95% CI: 3.514–10.812) for prolonged length of stay, 3.736 (95% CI: 2.620–5.328) for surgical complications, and 5.970, 95% CI: 4.088–8.720 for medical complications, all with significance. Conclusion Frailty is associated with increased risk for adverse inpatient outcomes, including prolonged hospital stay, surgical and medical complications and mortality independent of age and comorbidities in thyroid cancer patients undergoing surgery. Study findings may provide valuable information for preoperative risk stratification. |
| first_indexed | 2024-04-11T03:46:07Z |
| format | Article |
| id | doaj.art-1c6b8a66492f4c609cb2e3f92c518a1d |
| institution | Directory Open Access Journal |
| issn | 1916-0216 |
| language | English |
| last_indexed | 2025-02-17T09:56:40Z |
| publishDate | 2020-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj.art-1c6b8a66492f4c609cb2e3f92c518a1d2025-01-02T04:59:15ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162020-07-0149111110.1186/s40463-020-00450-5Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sampleDong Xu0Mengjia Fei1Yi Lai2Yuling Shen3Jiaqing Zhou4Department of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Head and Neck Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityAbstract Background Frailty is linked to perioperative morbidity and mortality. We evaluated the impact of preoperative frailty on inpatient outcomes of patients undergoing surgery for thyroid malignancy. Methods This population-based, retrospective observational study extracted data of hospitalized patients who were 18 years and older with a primary diagnosis of thyroid cancer undergoing thyroidectomy from the US Nationwide Inpatient Sample (NIS) database (2005–2014). Participants were stratified into frail and non-frail using the Johns Hopkins (ACG) frailty-defining diagnosis indicator. Study endpoints were in-hospital mortality, incidence of surgical and medical complications and prolonged length of stay. Univariate and multivariate analysis were performed to determine associations between the endpoints and frailty. Results Data of 38,202 patients were included. After adjusting for possible confounders, frailty remained significantly associated with higher odds of in-hospital mortality (OR: 3.839, 95% CI: 1.738–8.480), prolonged length of stay (OR: 5.420, 95% CI: 3.799–7.733), surgical complications (OR: 3.144, 95% CI: 2.443–4.045) and medical complications (OR: 6.734, 95% CI: 5.099–8.893) compared with non-frailty. In patients > age 65 years, adjusted odds ratio for frailty was 4.099 (95% CI: 1.736–9.679) for in-hospital mortality, 6.164 (95% CI: 3.514–10.812) for prolonged length of stay, 3.736 (95% CI: 2.620–5.328) for surgical complications, and 5.970, 95% CI: 4.088–8.720 for medical complications, all with significance. Conclusion Frailty is associated with increased risk for adverse inpatient outcomes, including prolonged hospital stay, surgical and medical complications and mortality independent of age and comorbidities in thyroid cancer patients undergoing surgery. Study findings may provide valuable information for preoperative risk stratification.http://link.springer.com/article/10.1186/s40463-020-00450-5FrailtyNational inpatient sample (NIS)Thyroid cancerThyroidectomy |
| spellingShingle | Dong Xu Mengjia Fei Yi Lai Yuling Shen Jiaqing Zhou Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample Journal of Otolaryngology - Head and Neck Surgery Frailty National inpatient sample (NIS) Thyroid cancer Thyroidectomy |
| title | Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample |
| title_full | Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample |
| title_fullStr | Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample |
| title_full_unstemmed | Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample |
| title_short | Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample |
| title_sort | impact of frailty on inpatient outcomes in thyroid cancer surgery 10 year results from the u s national inpatient sample |
| topic | Frailty National inpatient sample (NIS) Thyroid cancer Thyroidectomy |
| url | http://link.springer.com/article/10.1186/s40463-020-00450-5 |
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