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European Archives of Oto-Rhino-Laryngology

17.05.2024 | Head and Neck

The risk of free flap revision and subsequent medical costs in patients with hypopharyngeal cancer

verfasst von: Chun-Hsien Ho, Sheng-Dean Luo, Wei-Chih Chen, Tai-Jan Chiu, Yu-Ming Wang, Shao-Chun Wu, Yao-Hsu Yang, Shau-Hsuan Li, Spencer Chia-Hao Kuo, Ching-Nung Wu

Erschienen in: European Archives of Oto-Rhino-Laryngology

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Abstract

Background

Few studies have examined the preoperative risks and healthcare costs related to free flap revision in hypopharyngeal cancer (HPC) patients.

Methods

A 20-year retrospective case–control study was conducted using the Chang Gung Research Database, focusing on HPC patients who underwent tumor excision and free flap reconstruction from January 1, 2001, to December 31, 2019. The impacts of clinical variables on the need for re-exploration due to free flap complications were assessed using logistic regression. The direct and indirect effects of these complications on medical costs were evaluated by causal mediation analysis.

Results

Among 348 patients studied, 43 (12.4%) developed complications requiring re-exploration. Lower preoperative albumin levels significantly increased the risk of complications (OR 2.45, 95% CI 1.12–5.35), especially in older and previously irradiated patients. Causal mediation analysis revealed that these complications explained 11.4% of the effect on increased hospitalization costs, after controlling for confounders.

Conclusions

Lower preoperative albumin levels in HPC patients are associated with a higher risk of microvascular free flap complications and elevated healthcare costs, underscoring the need for enhanced nutritional support before surgery in this population.

Level of evidence

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Titel: The risk of free flap revision and subsequent medical costs in patients with hypopharyngeal cancer
verfasst von: Chun-Hsien Ho
Sheng-Dean Luo
Wei-Chih Chen
Tai-Jan Chiu
Yu-Ming Wang
Shao-Chun Wu
Yao-Hsu Yang
Shau-Hsuan Li
Spencer Chia-Hao Kuo
Ching-Nung Wu
Publikationsdatum: 17.05.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08727-5

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The risk of free flap revision and subsequent medical costs in patients with hypopharyngeal cancer

Abstract

Background

Methods

Results

Conclusions

Level of evidence

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Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

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Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Level of evidence

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Neu im Fachgebiet HNO

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Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

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