title: Effect of comorbidity on short-term outcomes and cost of care after head and neck cancer surgery in the elderly.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Dane J
authors.initials: DJ
authors.lastname: Genther
authors.forename: Christine G
authors.initials: CG
authors.lastname: Gourin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000191:economics* / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006258:Head and Neck Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000601:surgery*; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000191:economics / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: Nationwide Inpatient Sample; comorbidity; elderly; head and neck neoplasms; surgery