The Utility of Comorbidity Indices in Assessing Head and Neck Surgery Outcomes: A Systematic Review

Title

The Utility of Comorbidity Indices in Assessing Head and Neck Surgery Outcomes: A Systematic Review

Creator

Kavya Pai
Carla Baaklini
Claudia I Cabrera
Akina Tamaki
Nicole Fowler
Nicole Maronian

Date

2022

Description

Objective: To evaluate the utility of comorbidity index (CI) scores in predicting outcomes in head and neck surgery (HNS). The CIs evaluated were the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Kaplan-Feinstein Index (KFI), American Society of Anesthesiologists Physical Status (ASA-PS), Adult Comorbidity Evaluation-27 (ACE-27), National Cancer Institute Comorbidity Index (NCI-CI), and the Washington University Head and Neck Comorbidity Index (WUHNCI).

Methods: We report a systematic review according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases (PubMed, Cochrane, and Embase) and manual search of bibliographies identified manuscripts addressing how CI scores related to HNS outcomes.

Results: A total of 116 studies associated CI scores with HNS outcomes. CIs were represented in the literature as follows: ASA-PS (70/116), CCI (39/116), ACE-27 (24/116), KFI (7/116), NCI-CI (3/116), ECI (2/116), and WUHNCI (1/116). The most frequently cited justification for calculating each CI (if provided) was: CCI for its validation in other studies, ACE-27 for its utility in cancer patients, and ECI for its comprehensive design. In general, the CCI and ACE-27 were predictive of mortality in HNS. The ECI was most consistent in predicting >1-year mortality. The ACE-27 and KFI were most consistent in predicting medical complications.

Conclusion: Despite inconsistencies in the literature, CIs provide insights into the impact of comorbidities on outcomes in HNS. These scores should be employed as an adjunct in the preoperative assessment of HNS patients. Comparative studies are needed to identify indices that are most reliable in predicting HNS outcomes.

Level of evidence: NA Laryngoscope, 132:1388-1402, 2022.

Source

Laryngoscope
. 2022 Jul;132(7):1388-1402. doi: 10.1002/lary.29905. Epub 2021 Oct 18.

Language

English

Citation

Kavya Pai et al., “The Utility of Comorbidity Indices in Assessing Head and Neck Surgery Outcomes: A Systematic Review,” NEOMED Bibliography Database, accessed November 10, 2024, https://neomed.omeka.net/items/show/12100.