Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2010-2-23
pubmed:abstractText
The French national health insurance reimbursement system has recently changed from a global hospital funding system to casemix-based funding. The authors studied the factors likely to influence the length of hospital stay for free flap reconstructions after surgery for cancers of the oral cavity or pharynx. Data concerning 207 oral cavity or pharynx free flap reconstructions were extracted from a prospective registration. Lengths of hospital stay were compared by an analysis of variance F test or a nonparametric Kruskal-Wallis test, and transfusion rates were compared by Chi-square test or Fisher's exact test, as appropriate. The median length of hospital stay was 24 days (range: 7-145 days). Length of hospital stay was significantly longer according to the type of flap (p<0.005), in N2-N3 patients (p<0.02), a PINI score more than 10, a 3-4 American Society of Anesthesiologists (ASA) score, the presence of a tracheotomy and in patients requiring transfusion (p<0.0001). As the nodal status, the American Society of Anesthesiologists (ASA) score of the patient, the need of tracheotomy and the type of flap cannot be corrected, the management of preoperative haemoglobin and nutritional status are the sole factors which can improve the length of hospital stay. In the context of the new casemix-based funding, this study raises the problem of harvesting of the fibula flap, management of preoperative haemoglobin and nutritional status.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
1368-8375
pubmed:author
pubmed:copyrightInfo
(c) 2009 Elsevier Ltd. All rights reserved.
pubmed:issnType
Print
pubmed:volume
46
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
190-4
pubmed:meshHeading
pubmed-meshheading:20060773-Adolescent, pubmed-meshheading:20060773-Adult, pubmed-meshheading:20060773-Aged, pubmed-meshheading:20060773-Aged, 80 and over, pubmed-meshheading:20060773-Carcinoma, Squamous Cell, pubmed-meshheading:20060773-Child, pubmed-meshheading:20060773-Diagnosis-Related Groups, pubmed-meshheading:20060773-Female, pubmed-meshheading:20060773-France, pubmed-meshheading:20060773-Graft Survival, pubmed-meshheading:20060773-Head and Neck Neoplasms, pubmed-meshheading:20060773-Humans, pubmed-meshheading:20060773-Length of Stay, pubmed-meshheading:20060773-Male, pubmed-meshheading:20060773-Middle Aged, pubmed-meshheading:20060773-National Health Programs, pubmed-meshheading:20060773-Postoperative Complications, pubmed-meshheading:20060773-Prospective Studies, pubmed-meshheading:20060773-Reconstructive Surgical Procedures, pubmed-meshheading:20060773-Surgical Flaps, pubmed-meshheading:20060773-Treatment Outcome, pubmed-meshheading:20060773-Young Adult
pubmed:year
2010
pubmed:articleTitle
Study of the length of hospital stay for free flap reconstruction of oral and pharyngeal cancer in the context of the new French casemix-based funding.
pubmed:affiliation
Head and Neck Oncologic Surgery Unit, Institut Curie, 26 rue d'Ulm, 75005 Paris, France. angelique.girod@curie.net
pubmed:publicationType
Journal Article