{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:40:00Z","timestamp":1782232800427,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,9,23]],"date-time":"2016-09-23T00:00:00Z","timestamp":1474588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"American Academy of Otolaryngology-Head and Neck Surgery Percy Memorial Research Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine 30\u2010day readmission rates and associations with risk factors, survival, length of hospitalization, and costs in elderly patients with laryngeal and oropharyngeal squamous cell cancer (SCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cross\u2010sectional analysis of Surveillance, Epidemiology, and End Results\u2010Medicare data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated 1,518 patients diagnosed with laryngeal or oropharyngeal SCC from 2004 to 2007 who underwent primary surgery using cross\u2010tabulations, multivariate regression modeling, and survival analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010day readmission occurred in 14.1% of hospitalizations. Readmission was more likely in patients with postoperative complications during initial hospitalization (24.8% vs. 4.5%, <jats:italic>P<\/jats:italic> &lt; 0.001), and was associated with an increased 30\u2010day mortality incidence rate (5.1% vs. 0.9%; <jats:italic>P<\/jats:italic> &lt; 0.001). On multivariate analysis, 30\u2010day readmission was significantly associated with advanced stage (odds ratio [OR] = 1.81 [1.13\u20132.90]), comorbidity (OR = 2.69 [1.65\u20134.39]), divorced\/separated marital status (OR = 2.00 [1.19\u20133.38]), preoperative tracheostomy (OR = 3.39 [1.55\u20137.44]), major surgical procedures (OR = 2.58 [1.68\u20133.97]), greater length of initial hospitalization (OR = 1.72 [1.09\u20132.71]), pneumonia (OR = 2.86 [1.28\u20136.40]), postoperative dysphagia (OR = 5.97 [2.48\u201315.83]), and cardiovascular events (OR = 5.84 [1.89\u201317.96]). Thirty\u2010day readmission was significantly associated with 30\u2010day mortality (OR = 5.89 [2.21\u201315.70) and higher 1\u2010year mortality (68.0% vs. 89.2%, <jats:italic>P<\/jats:italic> &lt; 0.001). The mean incremental costs of surgical care were significantly greater for patients with unplanned readmission ($15,123 [$10,514\u2013$19,732]), after controlling for all other variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unplanned readmissions are associated with increased short\u2010 and long\u2010term mortality and costs. Elderly patients with advanced disease, advanced comorbidity, lack of spousal support, pretreatment organ dysfunction, more extensive surgery, postoperative pneumonia, postoperative dysphagia, and prolonged hospitalization are at increased risk of 30\u2010day readmission. These findings suggest a need for targeted interventions before, during, and after hospitalization to reduce morbidity, mortality, and excess costs in this high\u2010risk population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c. <jats:italic>Laryngoscope<\/jats:italic>, 127:631\u2013641, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26311","type":"journal-article","created":{"date-parts":[[2016,9,23]],"date-time":"2016-09-23T10:57:13Z","timestamp":1474628233000},"page":"631-641","source":"Crossref","is-referenced-by-count":54,"title":["Readmission following primary surgery for larynx and oropharynx cancer in the elderly"],"prefix":"10.1002","volume":"127","author":[{"given":"Hamad","family":"Chaudhary","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins Medical Institutions Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Matthew","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins Medical Institutions Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Webster","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins Medical Institutions Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Herbert","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management the Johns Hopkins Bloomberg School of Public Health Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin D.","family":"Frick","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management the Johns Hopkins Bloomberg School of Public Health Baltimore Maryland U.S.A."},{"name":"Johns Hopkins Carey Business School Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Eisele","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins Medical Institutions Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine G.","family":"Gourin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins Medical Institutions Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,23]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"National Health Expenditures 2014 Highlights. December 3 2015. Available at:https:\/\/www.cms.gov\/Research\u2010Statistics\u2010Data\u2010and\u2010Systems\/Statistics\u2010Trends\u2010and\u2010Reports\/NationalHealthExpendData\/downloads\/highlights.pdf. Accessed January 11 2016."},{"key":"e_1_2_6_3_1","unstructured":"HermanB.Health spending growth rate surges to 5.3% under ACA. Available at:http:\/\/www.modernhealthcare.com\/article\/20151202\/NEWS\/151209970. Accessed January 3 2016."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzv090"},{"key":"e_1_2_6_5_1","unstructured":"BoccutiC CasillasG.Aiming for Fewer Hospital U\u2010turns: the Medicare Hospital Readmission Reduction Program. January 29 2015. Available at:http:\/\/kff.org\/medicare\/issue\u2010brief\/aiming\u2010for\u2010fewer\u2010hospital\u2010u\u2010turns\u2010the\u2010medicare\u2010hospital\u2010readmission\u2010reduction\u2010program\/. 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