TY - JOUR
T1 - Use of the G8 Geriatric Screening Tool in Surgical Head and Neck Cancer Patients Requiring Rehabilitation
T2 - A Multisite Investigation
AU - Palmer, Andrew D.
AU - Starmer, Heather
AU - Sathe, Nishad
AU - Yao, Theresa Jingyun
AU - Bolognone, Rachel K.
AU - Edwards, Jeffrey
AU - Crino, Carrie
AU - Kizner, Jennifer
AU - Graville, Donna J.
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/2
Y1 - 2024/2
N2 - 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.
AB - 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.
KW - geriatrics
KW - head and neck cancer
KW - preoperative assessment
KW - rehabilitation
KW - speech pathology
UR - http://www.scopus.com/inward/record.url?scp=85167409917&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85167409917&partnerID=8YFLogxK
U2 - 10.1177/00034894231191869
DO - 10.1177/00034894231191869
M3 - Article
C2 - 37551009
AN - SCOPUS:85167409917
SN - 0003-4894
VL - 133
SP - 158
EP - 168
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
IS - 2
ER -