Nutritional Status and Outcomes Following Open Laryngeal Surgery for Laryngeal Cancer: A NSQIP Database Study.

OBJECTIVES

Malnutrition and weight loss in patients with laryngeal cancer impair immune function and wound healing. Understanding how underweight status impacts outcomes is crucial to improving care. Accordingly, we evaluated perioperative outcomes of patients undergoing laryngectomy for laryngeal cancer, with a secondary focus on patients with recent unintentional weight loss.

METHODS

This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database. CPT codes were used to identify patients undergoing open total or partial laryngectomies for cancer. Only those with underweight (< 18.5) or normal weight (18.5-29.9) BMIs were included. A subgroup analysis assessed patients with recent unintentional weight loss. Univariate and multivariate analyses were performed, with significance set at p < 0.05.

RESULTS

2012 patients were analyzed: 276 underweight (79 female, 197 male) and 1736 normal weight (306 female, 1430 male). Age distribution among underweight patients was 2.5% (ages 20-44), 76.1% (ages 45-69), and 21.4% (ages 70-90), compared to 2.9%, 66.7%, and 30.1%, respectively, in normal-weight patients. Underweight patients were more likely to experience medical complications (p < 0.001), longer hospital stays (p < 0.001), wound disruptions (p = 0.002), and to have greater transfusion requirements (p < 0.001). In those with recent, unintentional weight loss, underweight individuals were at increased risk of experiencing medical complications (p = 0.046) and requiring a transfusion (p < 0.001), but were not more likely to experience wound disruptions (p = 0.119) or experience increased lengths of stay (p = 0.225).

CONCLUSION

Underweight status and recent weight loss are associated with heightened risks of perioperative medical complications and transfusions. Preoperative optimization may enhance surgical recovery and outcomes.

LEVEL OF EVIDENCE: Level 3.