(501) Tongue Strength and Frailty in Head and Neck Cancer Patients

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Has Audio

Co-Author(s)

AA

Alberto A. Arteaga, MD

University of Mississippi Medical Center
Jackson, MS, USA

Presenting Author(s)

Boris Kuyeb, MS

MS3
University of Mississippi Medical Center
Jackson, Mississippi, United States

Co-Author(s)

KP

Kristen Pitts, MD

Spartanburg ENT, USA
CS

Christopher Spankovich, AuD, PhD

Associate Professor
University of Mississippi Medical Center
Jackson, Mississippi, USA
GJ

Gina Jefferson, md

University of Mississippi Medical Center, USA

Senior Author(s)

LJ

Lana Jackson, md

Lana Jackson
University of Mississippi Medical Center
Jackson, Mississippi, United States

Disclosure(s):

Boris Kuyeb, MS: No relevant relationships to disclose.

Introduction: Frailty has been significantly associated with perioperative morbidity and mortality in H&N cancer patients. Our study investigates tongue strength as a novel frailty indicator. The study aims to determine if tongue strength correlates with other frailty indexes and if it is predictive of perioperative outcomes/complications.

Methods: Prospective, cross-sectional study conducted between October 2017 and January 2023, including adult patients with H&N cancer, excluding melanoma, thyroid, parathyroid, esophageal primaries, and pregnant women. Fried Frailty index, Johns Hopkins Adjusted Clinical Groups, the ACS National Surgical Quality Improvement Program modified Frailty Index (NSQIP mFI), ASA, and tongue strength (assessed with Iowa oral performance instrument) were obtained. Correlations and regression models were used to investigate if tongue strength correlated with Frailty indexes and if tongue strength and Frailty indexes were predictive of outcomes, including hospital and ICU stay, discharge disposition, ER visits, readmission, Clavien Dindo IV complications, wound infections/dehiscence, fistula, flap failure, unplanned PEG tube placement/dependence.

Results: There was a significant negative correlation between tongue strength and Fried frailty index (r= -0.433, p=.003). Regression models showed that tongue strength was predictive of ICU stay (r= -0.355, p=.018). Fried frailty index-Frail patients had higher odds of a longer ICU stay (r=.335, p=.025). Hopkins ACG scores correlated with discharge disposition (r=0.372, p=.012). The remaining correlations were not statistically significant.

Conclusions: The utility and reliability of tongue strength in H&N surgery are still being investigated. Preliminary analysis revealed that tongue strength correlated with frailty score and ICU stay. Tongue strength might be an efficient tool for frailty screening with potential pre-surgical interventions. Future directions include studying the effect of tongue strength rehabilitation in patients undergoing major head and neck surgery.