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Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample
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 patien...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376848/ https://www.ncbi.nlm.nih.gov/pubmed/32698891 http://dx.doi.org/10.1186/s40463-020-00450-5 |
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author | Xu, Dong Fei, Mengjia Lai, Yi Shen, Yuling Zhou, Jiaqing |
author_facet | Xu, Dong Fei, Mengjia Lai, Yi Shen, Yuling Zhou, Jiaqing |
author_sort | Xu, Dong |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7376848 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73768482020-07-23 Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample Xu, Dong Fei, Mengjia Lai, Yi Shen, Yuling Zhou, Jiaqing J Otolaryngol Head Neck Surg Original Research Article 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. BioMed Central 2020-07-22 /pmc/articles/PMC7376848/ /pubmed/32698891 http://dx.doi.org/10.1186/s40463-020-00450-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Research Article Xu, Dong Fei, Mengjia Lai, Yi Shen, Yuling Zhou, Jiaqing Impact of frailty on inpatient outcomes in thyroid cancer surgery: 10-year results from the U.S. national inpatient sample |
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 | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376848/ https://www.ncbi.nlm.nih.gov/pubmed/32698891 http://dx.doi.org/10.1186/s40463-020-00450-5 |
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