Mortality during In-Hospital Treatment for Head and Neck Cancer in Germany: A Diagnosis-Related Group-Based Nationwide Analysis, 2005–2018

Abstract

Background. Data on in-hospital MR (IHMR) of head and neck cancer (HNC) are sparse. Methods. IHMR was determined in Germany between 2005 and 2018 using nationwide population-based diagnosis-related group (DRG) data of 1,090,596 HNC. Results. The overall average IHMR was $0.04\pm 0.02$ . IHMR increased with older age to $0.04\pm 0.01$ for patients of 65-79 years of age (relative risk [RR] in relation to patients of 35-49 years of $\text{age}=1.767$ ; $95\%\text{confidence}\text{interval}\left[\text{CI}\right]=1.040$ to3.001) to a maximum of $0.07\pm 0.01$ for patients of 80 years and older ( $\text{RR}=2.826$ ; $\text{CI}=1.663$ to 4.803). IHMR was the highest when no HNC-specific treatment, i.e., best supportive and palliative care, was applied ( $0.11\pm 0.01$ ; RR in relation to $\text{tumor}\text{biopsy}\text{surgery}=7.241$ ; $\text{CI}=3.447$ to 5.211). IHMR was not different between surgery, radiotherapy, or chemotherapy/biologicals. Conclusions. IHMR did not change over time. Efforts are needed to decrease the IHMR for HNC.