Prevalence and impact of complications on outcomes in patients hospitalized for oral and oropharyngeal cancer treatment

Objective We studied the association between presence of complications and hospitalization outcomes, including hospital charges, length of stay in hospital, and in-hospital mortality. Methods The Nationwide Inpatient Sample for 2008 was used. All hospital discharges with a primary diagnosis of oral and oropharyngeal cancers were selected. Presence of complications was determined by using ICD-9-CM codes. The association between the presence of complications and outcomes (hospital charges, length of stay, and in-hospital mortality) was examined by multivariable linear and multivariable logistic regression analyses. The effects of several patient- and hospital-related confounders were adjusted in the regression analyses. Results A total of 17,632 hospitalizations were attributed to oral and oropharyngeal cancers. A total of 519 (2.9%) patients died in the hospitals. The total hospitalization charges were close to $1.08 billion. Oral and oropharyngeal cancers accounted for 117,472 hospitalization days (mean length of stay 6.6 days). The overall complication rate was 14.95%. The most frequently present complication was hemorrhagic complications. Among the different complications, septicemia was associated with the worst outcomes. Patients with septicemia were associated with the highest odds for in-hospital mortality (OR = 13.06, 95% CI = 3.81-48.50, P = .0001). Conclusions Presence of complications was associated with poor outcomes, such as high in-hospital mortality rates, excess hospitalization charges, and longer length of stay in hospital. Among the different complications, septicemia was associated with the worst outcomes.