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Clinical and Experimental Otorhinolaryngology > Epub ahead of print
doi: https://doi.org/10.21053/ceo.2024.00257    [Epub ahead of print]
Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System
Heejun Yi1 , Hyojun Kim2 , Younghac Kim2 , Ye-Jin Suh2 , Joo Hyun Park2 , Nayeon Choi2 , Han-Sin Jeong2
1Department of Otorhinolaryngology-Head and Neck Surgery, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
2Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Han-Sin Jeong ,Tel: +82-2-3410-3579, Fax: +82-2-3410-6987, Email: hansin.jeong@samsung.com
Received: August 27, 2024; Revised: November 27, 2024   Accepted: December 2, 2024.  Published online: December 2, 2024.
ABSTRACT
Objectives
. A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.
Methods
. This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.
Results
. The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1–4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2–4, 8.6%–12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.
Conclusion
. The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.
Keywords: Head and Neck Cancer; Treatment; Emergency; Risk Factors
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