Skeletal Muscle Index's Impact on Discharge Disposition After Head and Neck Cancer Free Flap Reconstruction
To determine the role of skeletal muscle index (SMI) in the assessment of frailty and determination of discharge to post-acute care facilities (PACF) after head and neck cancer free flap reconstruction (HNCFFR).OBJECTIVETo determine the role of skeletal muscle index (SMI) in the assessment of frailt...
Saved in:
| Published in: | Otolaryngology-head and neck surgery Vol. 165; no. 1; p. 59 |
|---|---|
| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
01.07.2021
|
| ISSN: | 1097-6817, 1097-6817 |
| Online Access: | Get more information |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | To determine the role of skeletal muscle index (SMI) in the assessment of frailty and determination of discharge to post-acute care facilities (PACF) after head and neck cancer free flap reconstruction (HNCFFR).OBJECTIVETo determine the role of skeletal muscle index (SMI) in the assessment of frailty and determination of discharge to post-acute care facilities (PACF) after head and neck cancer free flap reconstruction (HNCFFR).Retrospective cohort.STUDY DESIGNRetrospective cohort.Single-institution, academic tertiary referral center.SETTINGSingle-institution, academic tertiary referral center.Adult patients undergoing HNCFFR from 2014 to 2019 with preoperative abdominal computed tomography imaging were retrospectively analyzed. Patient demographics, 5-factor modified frailty index (5-mFI), body mass index (BMI), SMI at the third lumbar vertebra, oncologic history, perioperative data, and Clavien-Dindo (CD) complications were collected. Binary logistic regression was used to identify independent predictors of discharge disposition.METHODSAdult patients undergoing HNCFFR from 2014 to 2019 with preoperative abdominal computed tomography imaging were retrospectively analyzed. Patient demographics, 5-factor modified frailty index (5-mFI), body mass index (BMI), SMI at the third lumbar vertebra, oncologic history, perioperative data, and Clavien-Dindo (CD) complications were collected. Binary logistic regression was used to identify independent predictors of discharge disposition.The cohort consisted of 206 patients, 62 (30.1%) of whom were discharged to PACF. Patients discharged to PACF were of older age (65.4 vs 57.1 years, P < .0001) and had a lower SMI (38.8 vs 46.8 cm2/m2, P < .0001), higher 5-mFI (≥3; 25.8% vs 4.2%, P < .0001), and greater incidence of stage IV (80.6% vs 64.1%, P = .0211) aerodigestive cancer (80.6% vs 66.7%, P = .0462). Patients discharged to PACF experienced more blood transfusions (74.2% vs 35.4%, P < .0001), major postoperative complications (CD ≥3, 40.3% vs 12.9%, P < .0001), and delirium (33.9% vs 4.2%, P < .0001). After adjusting for pre- and postoperative factors, multivariate binary logistic regression identified age (P = .0255), 5-mFI (P < .0042), SMI (P = .0199), stage IV cancer (P = .0250), aerodigestive tumor (P = .0366), delirium (P < .0001), and perioperative blood transfusion (P = .0144) as independent predictors of discharge to PACF.RESULTSThe cohort consisted of 206 patients, 62 (30.1%) of whom were discharged to PACF. Patients discharged to PACF were of older age (65.4 vs 57.1 years, P < .0001) and had a lower SMI (38.8 vs 46.8 cm2/m2, P < .0001), higher 5-mFI (≥3; 25.8% vs 4.2%, P < .0001), and greater incidence of stage IV (80.6% vs 64.1%, P = .0211) aerodigestive cancer (80.6% vs 66.7%, P = .0462). Patients discharged to PACF experienced more blood transfusions (74.2% vs 35.4%, P < .0001), major postoperative complications (CD ≥3, 40.3% vs 12.9%, P < .0001), and delirium (33.9% vs 4.2%, P < .0001). After adjusting for pre- and postoperative factors, multivariate binary logistic regression identified age (P = .0255), 5-mFI (P < .0042), SMI (P = .0199), stage IV cancer (P = .0250), aerodigestive tumor (P = .0366), delirium (P < .0001), and perioperative blood transfusion (P = .0144) as independent predictors of discharge to PACF.SMI and 5-mFI are independently associated with discharge to PACF after HNCFFR and should be considered in preoperative planning and assessment of frailty.CONCLUSIONSSMI and 5-mFI are independently associated with discharge to PACF after HNCFFR and should be considered in preoperative planning and assessment of frailty. |
|---|---|
| AbstractList | To determine the role of skeletal muscle index (SMI) in the assessment of frailty and determination of discharge to post-acute care facilities (PACF) after head and neck cancer free flap reconstruction (HNCFFR).OBJECTIVETo determine the role of skeletal muscle index (SMI) in the assessment of frailty and determination of discharge to post-acute care facilities (PACF) after head and neck cancer free flap reconstruction (HNCFFR).Retrospective cohort.STUDY DESIGNRetrospective cohort.Single-institution, academic tertiary referral center.SETTINGSingle-institution, academic tertiary referral center.Adult patients undergoing HNCFFR from 2014 to 2019 with preoperative abdominal computed tomography imaging were retrospectively analyzed. Patient demographics, 5-factor modified frailty index (5-mFI), body mass index (BMI), SMI at the third lumbar vertebra, oncologic history, perioperative data, and Clavien-Dindo (CD) complications were collected. Binary logistic regression was used to identify independent predictors of discharge disposition.METHODSAdult patients undergoing HNCFFR from 2014 to 2019 with preoperative abdominal computed tomography imaging were retrospectively analyzed. Patient demographics, 5-factor modified frailty index (5-mFI), body mass index (BMI), SMI at the third lumbar vertebra, oncologic history, perioperative data, and Clavien-Dindo (CD) complications were collected. Binary logistic regression was used to identify independent predictors of discharge disposition.The cohort consisted of 206 patients, 62 (30.1%) of whom were discharged to PACF. Patients discharged to PACF were of older age (65.4 vs 57.1 years, P < .0001) and had a lower SMI (38.8 vs 46.8 cm2/m2, P < .0001), higher 5-mFI (≥3; 25.8% vs 4.2%, P < .0001), and greater incidence of stage IV (80.6% vs 64.1%, P = .0211) aerodigestive cancer (80.6% vs 66.7%, P = .0462). Patients discharged to PACF experienced more blood transfusions (74.2% vs 35.4%, P < .0001), major postoperative complications (CD ≥3, 40.3% vs 12.9%, P < .0001), and delirium (33.9% vs 4.2%, P < .0001). After adjusting for pre- and postoperative factors, multivariate binary logistic regression identified age (P = .0255), 5-mFI (P < .0042), SMI (P = .0199), stage IV cancer (P = .0250), aerodigestive tumor (P = .0366), delirium (P < .0001), and perioperative blood transfusion (P = .0144) as independent predictors of discharge to PACF.RESULTSThe cohort consisted of 206 patients, 62 (30.1%) of whom were discharged to PACF. Patients discharged to PACF were of older age (65.4 vs 57.1 years, P < .0001) and had a lower SMI (38.8 vs 46.8 cm2/m2, P < .0001), higher 5-mFI (≥3; 25.8% vs 4.2%, P < .0001), and greater incidence of stage IV (80.6% vs 64.1%, P = .0211) aerodigestive cancer (80.6% vs 66.7%, P = .0462). Patients discharged to PACF experienced more blood transfusions (74.2% vs 35.4%, P < .0001), major postoperative complications (CD ≥3, 40.3% vs 12.9%, P < .0001), and delirium (33.9% vs 4.2%, P < .0001). After adjusting for pre- and postoperative factors, multivariate binary logistic regression identified age (P = .0255), 5-mFI (P < .0042), SMI (P = .0199), stage IV cancer (P = .0250), aerodigestive tumor (P = .0366), delirium (P < .0001), and perioperative blood transfusion (P = .0144) as independent predictors of discharge to PACF.SMI and 5-mFI are independently associated with discharge to PACF after HNCFFR and should be considered in preoperative planning and assessment of frailty.CONCLUSIONSSMI and 5-mFI are independently associated with discharge to PACF after HNCFFR and should be considered in preoperative planning and assessment of frailty. |
| Author | Bonetto, Andrea Campiti, Vincent Joseph Alwani, Mohamedkazim Novinger, Leah J Jones, Alexander Joseph Moore, Michael G Mantravadi, Avinash V Sim, Michael W Yesensky, Jessica A |
| Author_xml | – sequence: 1 givenname: Alexander Joseph surname: Jones fullname: Jones, Alexander Joseph – sequence: 2 givenname: Vincent Joseph surname: Campiti fullname: Campiti, Vincent Joseph – sequence: 3 givenname: Mohamedkazim surname: Alwani fullname: Alwani, Mohamedkazim – sequence: 4 givenname: Leah J surname: Novinger fullname: Novinger, Leah J – sequence: 5 givenname: Andrea surname: Bonetto fullname: Bonetto, Andrea – sequence: 6 givenname: Michael W surname: Sim fullname: Sim, Michael W – sequence: 7 givenname: Jessica A surname: Yesensky fullname: Yesensky, Jessica A – sequence: 8 givenname: Michael G surname: Moore fullname: Moore, Michael G – sequence: 9 givenname: Avinash V surname: Mantravadi fullname: Mantravadi, Avinash V |
| BookMark | eNpNj0tLw0AUhQepYFvdu5ydbqLzSOaxLNW0hargY11uZ260djqJmQT8-abowtX5-OAcOBMyinVEQi45u-Fc61vGbV5YawSzWgopTsiYD5gpw_XoH5-RSUqfjDGltB6T_cseA3YQ6EOfXEC6ih6_rxJdHRpwHa0jvdsl9wHtOx6pqdOu2w12VnXY0iWCpxA9fUS3p3OIbpBli0jLAA19RlfH1LW9O3bOyWkFIeHFX07JW3n_Ol9m66fFaj5bZy4XVmTeGDRgnfaOa-4rI2VhEaStlANTMeM9KHDeKM25knLQnBXbwm-dkJgLMSXXv7tNW3_1mLrNYbiAIUDEuk8bkSujCiMZFz9boV4M |
| CitedBy_id | crossref_primary_10_1002_hed_27072 crossref_primary_10_1097_MOO_0000000000000792 crossref_primary_10_1002_hed_28014 crossref_primary_10_1186_s13005_024_00439_9 crossref_primary_10_1016_j_arr_2021_101515 crossref_primary_10_1002_lio2_530 crossref_primary_10_1002_hed_27110 crossref_primary_10_1002_ohn_557 crossref_primary_10_1016_j_jgo_2024_102064 crossref_primary_10_1002_hed_27789 crossref_primary_10_1016_j_bjps_2022_11_018 crossref_primary_10_3389_fonc_2022_884988 crossref_primary_10_1111_ggi_14648 crossref_primary_10_1002_lary_31202 crossref_primary_10_1016_j_jormas_2024_102045 crossref_primary_10_3390_jcm12103445 |
| ContentType | Journal Article |
| DBID | 7X8 |
| DOI | 10.1177/0194599820973232 |
| DatabaseName | MEDLINE - Academic |
| DatabaseTitle | MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1097-6817 |
| GroupedDBID | --- 01A 123 1B1 1OB 1OC 354 4.4 53G 54M 5RE 71M 7X8 8F7 AABOD AAHQN AAIPD AAJQC AAMMB AAMNL AANLZ AAQQG AARDL AAWTL AAYCA ABAFQ ABAWP ABCCA ABJNI ABNCE ABQWH ABQXT ABVFX ACDXX ACGFS ACXQS ADBBV ADBTR ADEBD AEFGJ AEIGN AENEX AERKM AEUHG AEUYR AEWDL AFFPM AFKRG AFWVQ AGXDD AGYGG AHBTC AIDQK AIDYY AITYG AJUZI ALMA_UNASSIGNED_HOLDINGS ARTOV AUTPY AYAKG BDDNI BSEHC BYIEH C45 CS3 DCZOG DU5 EBS EO8 EO9 EP2 EP3 F5P FDB G-Q GROUPED_SAGE_PREMIER_JOURNAL_COLLECTION H13 HF~ HGLYW IHE J8X K.F LH4 MEWTI O9- OHH OVD OZT P.B Q1R ROL RPZ S01 SAUOL SCNPE SDG SDP SEL SFC SJN SUPJJ TEORI UGJ WH7 WXSBR ZY1 ~HD |
| ID | FETCH-LOGICAL-c4292-d88e8a9c7dc171df83359ea39f6ca8f08dda6acd86711633f6c105b5dbc23e422 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 17 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000669239300010&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1097-6817 |
| IngestDate | Thu Oct 02 09:39:52 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 1 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c4292-d88e8a9c7dc171df83359ea39f6ca8f08dda6acd86711633f6c105b5dbc23e422 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| PQID | 2468658301 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2468658301 |
| PublicationCentury | 2000 |
| PublicationDate | July 2021 |
| PublicationDateYYYYMMDD | 2021-07-01 |
| PublicationDate_xml | – month: 07 year: 2021 text: July 2021 |
| PublicationDecade | 2020 |
| PublicationTitle | Otolaryngology-head and neck surgery |
| PublicationYear | 2021 |
| SSID | ssj0006677 |
| Score | 2.418312 |
| Snippet | To determine the role of skeletal muscle index (SMI) in the assessment of frailty and determination of discharge to post-acute care facilities (PACF) after... |
| SourceID | proquest |
| SourceType | Aggregation Database |
| StartPage | 59 |
| Title | Skeletal Muscle Index's Impact on Discharge Disposition After Head and Neck Cancer Free Flap Reconstruction |
| URI | https://www.proquest.com/docview/2468658301 |
| Volume | 165 |
| WOSCitedRecordID | wos000669239300010&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LS8NAEF7UinjxLb5ZQfAU2myS3c1JSjW0hxZBhd7KZh9QKklNrL_fmTUl4EnwFsISwuTLzDc7s_MRcpeGznBm40AJAwmK7Lkg5znkPLlNWB5KaXPpxSbEZCKn0_S52XCrm7bKtU_0jtqUGvfIuyzmEqIl4PFh-RGgahRWVxsJjU3SiYDKIKrFtJ0WzrlXXsQia8BlKNoyZReYTZxAqsH8uBoUH_nlin18yfb_-2YHZK9hlrT_A4VDsmGLI7Izbmrnx2TxsoAQA1ybjlc1rKAjHJR4X9ORPyhJy4I-zms_Ocni1bqdi_ZRRpwOAQxUFYZOrF7QAYKlolllLc3e1ZJiGtsOoz0hb9nT62AYNFILgUa9qsDAR5Eq1cLoUITG4VGs1KoodVwr6XrSGMWVNjgNDxhcBLeBmOWJyTWLbMzYKdkqysKeEQoPjJy0SB5lDPknMAINxneRSJSSIjont2szzgDKWJ9QhS1X9aw15MUf1lySXYb9Jb519op0HPyu9pps66_PeV3deCR8A0bdvEM |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Skeletal+Muscle+Index%27s+Impact+on+Discharge+Disposition+After+Head+and+Neck+Cancer+Free+Flap+Reconstruction&rft.jtitle=Otolaryngology-head+and+neck+surgery&rft.au=Jones%2C+Alexander+Joseph&rft.au=Campiti%2C+Vincent+Joseph&rft.au=Alwani%2C+Mohamedkazim&rft.au=Novinger%2C+Leah+J&rft.date=2021-07-01&rft.issn=1097-6817&rft.eissn=1097-6817&rft.volume=165&rft.issue=1&rft.spage=59&rft_id=info:doi/10.1177%2F0194599820973232&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1097-6817&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1097-6817&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1097-6817&client=summon |