The Effect of Patient Frailty on Morbidity, Mortality and Overall Survival Following Laryngectomy Procedures

The present study evaluated the impact of frailty on patient morbidity and survival following laryngectomy surgery. A retrospective cohort study of patients undergoing laryngectomy over a 10-year period. Frailty was measured using the 5-item modified Frailty Index (5mFI). A total of 233 patients (mean [SD] age, 63.7 [±10.0] years) were included. Eighty-two (35.2%) patients were frail and frail patients had a greater mean age (66.3 vs. 62.2 years, p = 0.006). On multivariable regression, frail patients were more likely to: develop pharyngocutaneous fistula (OR 2.62, 95% CI 1.33-5.18, p = 0.006), have a longer hospital stay (β 25.53 days, 95% CI 14.64-36.41, p < 0.001) and be discharged to a non-home setting (OR 5.31, 95% CI 2.49-11.35, p < 0.001). In case-matched patients, 3-year overall survival (OS) was similar in frail and not frail patients (p = 0.715). Use of the 5mFI pre-laryngectomy may identify patients requiring increased support to optimise their peri-operative risk.