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Use of the G8 Geriatric Screening Tool in Surgical Head and Neck Cancer Patients Requiring Rehabilitation: A Multisite Investigation.
Palmer, Andrew D; Starmer, Heather; Sathe, Nishad; Yao, Theresa Jingyun; Bolognone, Rachel K; Edwards, Jeffrey; Crino, Carrie; Kizner, Jennifer; Graville, Donna J.
Affiliation
  • Palmer AD; Northwest Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA.
  • Starmer H; Department of Otolaryngology-Head & Neck Surgery, Stanford University, Stanford, CA, USA.
  • Sathe N; School of Medicine, Oregon Health & Science University, Portland, OR, USA.
  • Yao TJ; Head and Neck Speech and Swallowing Rehabilitation Center, Stanford Healthcare, Stanford, CA USA.
  • Bolognone RK; Northwest Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA.
  • Edwards J; Head and Neck Speech and Swallowing Rehabilitation Center, Stanford Healthcare, Stanford, CA USA.
  • Crino C; Northwest Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA.
  • Kizner J; Head and Neck Speech and Swallowing Rehabilitation Center, Stanford Healthcare, Stanford, CA USA.
  • Graville DJ; Northwest Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA.
Ann Otol Rhinol Laryngol ; 133(2): 158-168, 2024 Feb.
Article in En | MEDLINE | ID: mdl-37551009
OBJECTIVES: The G8 is a well-validated screening test for older cancer patients. The current study was undertaken to determine whether the G8 is predictive of short-term post-operative outcomes after head and neck cancer (HNC) surgery. METHODS: Consecutive patients aged 65 years or more and referred for a preoperative assessment by a speech-language pathologist were consecutively screened by clinicians at 2 academic medical centers using the G8. The G8 was used to screen for vulnerability prior to surgery. Patients were deemed vulnerable if they had a total G8 score ≤14 according to published guidelines. Data were also collected on demographic characteristics, tumor staging, post-operative course, and tracheostomy and feeding tube (FT) status. RESULTS: Ninety patients were consecutively screened during the study period. Using the G8, 64% of the patients were deemed vulnerable. Vulnerable patients differed significantly from non-vulnerable patients with regard to age, health, tumor stage, and baseline dysphagia, and underwent more extensive surgery. Postoperatively, vulnerable patients had a significantly longer hospital length of stay (LOS; 10.17 vs 5.50 days, respectively, P < .001), were less likely to discharge home (76% vs 94%, P = .044), and were more likely to be FT dependent for over a month (54% vs 21%, P = .006) compared to non-vulnerable patients. In regression models, controlling for T-stage and surgical variables, the G8 independently predicted 2 post-operative outcomes of interest, namely LOS and FT dependency. CONCLUSIONS: The G8 may be a useful screening tool for identifying older adults at risk of a protracted postoperative medical course after HNC surgery. Future research should aim to identify the optimal screening protocol and how this information can be incorporated into clinical pathways to enhance the post-operative outcomes of older HNC patients.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Head and Neck Neoplasms / Medicine Type of study: Diagnostic_studies / Guideline / Prognostic_studies / Screening_studies Limits: Aged / Humans Language: En Journal: Ann Otol Rhinol Laryngol Year: 2024 Document type: Article Affiliation country: United States Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Head and Neck Neoplasms / Medicine Type of study: Diagnostic_studies / Guideline / Prognostic_studies / Screening_studies Limits: Aged / Humans Language: En Journal: Ann Otol Rhinol Laryngol Year: 2024 Document type: Article Affiliation country: United States Country of publication: United States