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Outcomes for head and neck cancer patients admitted to intensive care in Australia and New Zealand between 2000 and 2016

Published online by Cambridge University Press:  22 June 2021

C A Frauenfelder ,
E P Raith ,
S Krishnan ,
A Udy  and
D Pilcher
C A Frauenfelder*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Australia Discipline of Surgery, School of Medicine, University of Adelaide, Australia
E P Raith
Affiliation:
Department of Intensive Care Medicine, Royal Adelaide Hospital, Australia Discipline of Acute Care Medicine, School of Medicine, University of Adelaide, Australia
S Krishnan
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Australia Discipline of Surgery, School of Medicine, University of Adelaide, Australia
A Udy
Affiliation:
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Australia Department of Intensive Care Medicine, Alfred Health, Prahran, Australia
D Pilcher
Affiliation:
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Australia Department of Intensive Care Medicine, Alfred Health, Prahran, Australia
*
Author for correspondence: Dr Claire Frauenfelder, c/o Department of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, North Terrace, South Australia5000, Australia E-mail: claire.frauenfelder@adelaide.edu.au
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Abstract

Objective

To report intensive care unit admission outcomes for head and neck cancer patients.

Methods

A retrospective, observational cohort analysis of all Australian and New Zealander head and neck cancer patient intensive care unit admissions from January 2000 to June 2016, including data from 192 intensive care units.

Results

There were 10 721 head and neck cancer patients, with a median age of 64 years (71.6 per cent male). Of admissions, 76.4 per cent were in public hospitals, 96.9 per cent were post-operative and 43.6 per cent required mechanical ventilation. Annual head and neck cancer admissions increased from 2000 to 2015 (from 348 to 1132 patients), but the overall proportion of intensive care unit admissions remained constant. In-hospital mortality was 2.7 per cent, and intensive care unit mortality was 0.7 per cent. The in-hospital mortality risk decreased three-fold (p < 0.001).

Conclusion

Head and neck cancer patients had low mortality in the intensive care unit and in hospital. Risk of dying decreased despite more intensive care unit admissions. This is the first large-scale cohort study quantifying intensive care unit utilisation by head and neck cancer patients. It informs future work investigating alternatives to the intensive care unit for these patients.

Keywords

Critical Care OutcomesDelivery Of Health CareHead And Neck NeoplasmsHospital Mortality
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 8 , August 2021 , pp. 702 - 709
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr C A Frauenfelder takes responsibility for the integrity of the content of the paper

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