Tracheostomy and infection prolong length of stay in hospital after surgery for head and neck cancer: a population based study.

Objective To determine the factors that predict length of stay (LOS) in hospital after head and neck cancer (HNC) surgery for patients treated in public hospitals in Ireland between 2002 and 2010. Study Design Cancer registry data on patients with carcinoma of the oropharynx/larynx were identified and linked with hospital in-patient discharge records. Associations between clinical (e.g., surgery type, neoadjuvant chemoradiation), health service factors, and LOS were investigated by using negative binomial regression. Results Of the patients diagnosed with HNC, 50% (n = 1651) underwent HNC surgery. Median LOS was 10 days (range: 1-289). Variables associated with prolonged LOS included tracheostomy (neck dissection + tracheostomy versus neck dissection only: incident rate ratio [IRR] 2.66; 95% confidence interval [CI] 2.01-3.50); postoperative infection (IRR 2.26; 95% CI 1.94-2.62); and neoadjuvant radiotherapy (IRR 2.15; 95% CI 1.64-2.82). Advanced stage, gastrostomy, and reconstruction were also associated with prolonged LOS. Conclusions Tracheostomy and postoperative infection were associated with prolonged LOS. Further investigation of these modifiable risk factors is warranted.