Elisabeth Hansen, MS

Pronouns

She/Her/Hers

Rank

Research Trainee

Institution

BWH

BWH-MGH Title

Research Trainee

Department

Surgery

Authors

Elisabeth E. Hansen*, Rosh Sethi, MD, MPH, Eleni M. Rettig, MD, Ravindra Uppaluri, MD PhD, Donald J. Annino, MD DMD, Laura A Goguen, MD FACS

Association of Frailty with Outcomes after Mandibulectomy with Osseous Free Flap Reconstruction

WMSS 2022

As a female medical student applying into otolaryngology-head and neck surgery, my female mentors have been extremely influential and supportive, and invaluable in helping me to develop my confidence in entering this field. I see participating in the Women and Medicine and Science Symposium as a way to further cultivate supportive professional relationships with women in research, which is something I plan to continue to seek out throughout my career. My research interests include clinical outcomes in head and neck cancer surgery and disparities in access to timely high quality care in otolaryngology-head and neck surgery.

Background

We sought to examine frailty among patients undergoing osseous free flap (OFF) mandibular reconstruction and to assess frailty as a predictor of outcomes.

Methods

Retrospective chart review of OFF mandibular reconstructions, January 2015–August 2021. A modified frailty index was calculated using preoperative comorbidities and functional status. Outcomes: inpatient Clavien-Dindo (CD) IV critical care, surgical site or medical complications; disposition; discharge with tracheostomy tube; length of stay (LOS); unplanned 30-day readmission. Frailty defined as ≥1 frailty-defining diagnosis.

Results

94 cases identified. Mean age: 64.4 years (SD 8.9). Fifty-three cases (56.4%) had ≥1 frailty-defining diagnosis: specifically, 1 (N=30, 56.6%), 2 (N=17, 32.1%) or 3 (N=6, 11.3%). Mean LOS: 12.7 days (SD 6.2). A minority of patients had any CD IV (N=6, 6.4%) or surgical site complication (N=40, 42.6%). Frailty was not associated with discharge to rehabilitation facility (p=0.326), discharge with tracheostomy tube (p=0.061), LOS (p=0.104), unplanned readmission (p=0.807), CD IV complication (p=0.227) or composite of post-operative complications (p=0.674).

Conclusion

To our knowledge this is the largest series assessing frailty in mandibulectomy with OFF reconstruction. We find a low degree of frailty and no association between frailty and outcomes, suggesting this operation can be safely performed for mildly frail patients.