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Factors Predisposing to the Unplanned Hospital Readmission (UHR) in Patients Undergoing Surgery for Oral Cavity Squamous Cell Carcinoma (OSCC): Experience from a Tertiary Cancer Centre

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Abstract

Unplanned hospital readmissions (UHR) are known to add to patient morbidity, increase the cost of the treatment, and negatively impact the postoperative quality of life. The objective of the study was to identify the UHR rates of oral cavity squamous cell carcinoma (OSCC) patients following surgery and identify the predisposing factors for UHR. We conducted this retrospective analysis of all patients who underwent surgery for OSCC in our (single) surgical unit from January 2016 to December 2018. A total of 804 patients satisfied the eligibility criteria. Majority of the patients were males (n = 650, 80.8%). The median age of the patients was 50 years (Range: 16–89 years). The most common oral cavity subsite was buccal mucosa gingivobuccal (BM-GBS) OSCC. Forty patients (5%) required an UHR after discharge. The most common reason for readmissions was flap-related issues (11/40) and orocutaneous fistula (10/40). Other causes included wound infection (7/40), chest infection (2/40), hematoma/bleeding (3/40), and other lesser prevalent causes (7/40). Factors that significantly predisposed patients for UHR were re-exploration following the initial surgery [p < 0.001, OR 7.9 (4.09–15.59)] and BM-GBS subsite [< 0.001, OR: 2.89(1.24–6.73)]. The UHR rate in our study was 5%. Patients requiring re-exploration following the initial surgery and those with BM-GBS cancer were most likely to have the UHR.

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Acknowledgments

Dr. Atanu Bhattacharjee, Assistant Professor, Department of Biostatistics, ACTREC, Navi Mumbai, Maharashtra, India.

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Authors and Affiliations

  1. Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India

    Shivakumar Thiagarajan, Shikhar Sawhney, Siddhanth Jain, Adhara Chakraborthy, Nandini Menon, Alaknanda Gupta & Devendra Chaukar

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  1. Shivakumar Thiagarajan
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  2. Shikhar Sawhney
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  4. Adhara Chakraborthy
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  7. Devendra Chaukar
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Contributions

Study Concepts: Shivakumar Thiagarajan, Devendra Chaukar, Shikhar Sawhney.

Study Design: Shivakumar Thiagarajan, Shikhar Sawhney.

Data Acquisition: Shikhar Sawhney, Adhara Chakraborthy, Siddhant Jain, Nandini Menon, Alaknanda Gupta.

Quality control of data and algorithms: Shivakumar Thiagarajan, Devendra Chaukar.

Statistical Analysis: Atanu Bhatacharjee, Shivakumar Thiagarajan, Shikhar Sawhney.

Manuscript preparation: All Authors.

Manuscript editing: Shivakumar Thiagarajan, Shikhar Sawhney, Devendra Chaukar.

Manuscript reviewing: All Authors.

Corresponding author

Correspondence to Shivakumar Thiagarajan.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

A retrospective clinical audit of an existing database. No patient contact was made. All patients received the standard of care for their condition and were as per the ethical standards.

Informed Consent

No identifying information about participants is available in the article. However, all patients have given consent for the treatment they have received.

Conference Presentation

This was presented as a poster at the FHNO 2019 meeting held in Chennai between October 11 and 13, 2019.

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Thiagarajan, S., Sawhney, S., Jain, S. et al. Factors Predisposing to the Unplanned Hospital Readmission (UHR) in Patients Undergoing Surgery for Oral Cavity Squamous Cell Carcinoma (OSCC): Experience from a Tertiary Cancer Centre. Indian J Surg Oncol 11, 475–481 (2020). https://doi.org/10.1007/s13193-020-01135-1

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  • DOI: https://doi.org/10.1007/s13193-020-01135-1

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