Quality of outcome (QoO) in oral cancer patients: prospective perioperative analysis of patients’ resilience and satisfaction during inpatient stay at a University Medical Centre in Germany

TL;DR

This study examines how patient resilience and satisfaction change before and after surgery for oral cancer patients in Germany, aiming to improve quality of outcomes.

Contribution

The study introduces a perioperative analysis of resilience and satisfaction as indicators for quality of outcome in oral cancer surgery.

Findings

Significant decreases in patient resilience and satisfaction were observed postoperatively in areas like enjoyable food and social recognition.

Most patients received tracheotomies postoperatively, and few had access to physiotherapy or psychological support preoperatively.

Shorter ICU stays could be achieved through minimally invasive surgical approaches.

Abstract

Quality assurance strategies for head and neck surgery can improve patient outcomes. This study aims a perioperative analysis of indicators in the quality of outcome in oral cancer patients with special focus on patient`s resilience and satisfaction before and after surgery.

Patients with oral cancer (OCP) and indication for surgical resection were included in a prospective study. General and disease-related data as well as parameters of patient-specific resilience (RS-11 questionnaire) and physical strength (ECOG-Score) were collected. Importance and satisfaction using the nine items family/friends, sports activities/physiotherapy, participation in culture, professional perspectives, sexuality, enjoyable food, external appearance, social recognition and independence were analysed. The data collection took place pre- and postoperatively (mean: 10th postop day) during the inpatient stay.

Twenty-eight patients with oral cancer (OCP) were analysed (male: n=23, female n=5). The rate of R0 resections was 92.6 %. The average length of stay was 21 days. n=16 of all patients was tracheotomised postop (preop: n=0). n=0 patients confirmed psycho(onco)logical support preop (postop: n=19). Sports activities/physiotherapy was provided to n=3 patients preop (postop: n=21). The mean pre and postop pain perception was 3/10. The RS-11 score decreased significantly postoperatively (p=0.01). A significant loss of satisfaction was seen in the areas of enjoyable food (p<0.001), social recognition (p=0.01), external appearance (p=0.01) and independence (p<0.001).

Supportive therapy measures to promote mental and physical fitness of oral cancer patients are part of inpatient care at our clinic. However, there is no standardised monitoring of these therapies. Digitally supported and standardised programmes to increase mental and physical fitness in both prehospital and inpatient care might lead to an improvement in the quality of outcome despite shortage of resources in terms of time, costs and personnel. A minimally invasive approach to tracheal cannula management and lymph node management in the treatment of OCP can help to reduce the length of stay in the intensive care unit.

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