Table 2.
Multivariable Analysis for Total Laryngectomy Utilization.
| Variable | Odds Ratio | 95% LCI | 95% UCI | p-Value | |
|---|---|---|---|---|---|
| Age | ≤61 years | REF | |||
| >61 years | 0.81 | 0.72 | 0.91 | <0.001 | |
| Facility Type | Community Cancer Program | REF | |||
| Comprehensive Community Cancer Program | 1.10 | 0.85 | 1.41 | 0.477 | |
| Academic/Research Program | 3.06 | 2.39 | 3.92 | <0.001 | |
| Integrated Network Cancer Program | 1.50 | 1.15 | 1.96 | 0.003 | |
| Facility Location | New England | REF | |||
| Middle Atlantic | 1.00 | 0.76 | 1.32 | 0.989 | |
| South Atlantic | 1.24 | 0.94 | 1.62 | 0.124 | |
| East North Central | 1.22 | 0.93 | 1.61 | 0.147 | |
| East South Central | 0.87 | 0.64 | 1.18 | 0.356 | |
| West North Central | 1.58 | 1.16 | 2.16 | 0.004 | |
| West South Central | 1.52 | 1.13 | 2.05 | 0.006 | |
| Mountain | 1.07 | 0.73 | 1.56 | 0.747 | |
| Pacific | 1.46 | 1.08 | 1.97 | 0.014 | |
| Sex | Female | REF | |||
| Male | 1.19 | 1.05 | 1.36 | 0.001 | |
| Ethnicity | Non-Hispanic | REF | |||
| Hispanic | 0.84 | 0.68 | 1.04 | 0.102 | |
| Unknown | 1.04 | 0.82 | 1.33 | 0.732 | |
| Insurance Type | Private Insurance/Managed Care | REF | |||
| Not Insured | 0.91 | 0.75 | 1.10 | 0.337 | |
| Medicaid | 1.31 | 1.12 | 1.52 | <0.001 | |
| Medicare | 0.97 | 0.84 | 1.11 | 0.628 | |
| Other Government | 0.83 | 0.56 | 1.22 | 0.345 | |
| Insurance Status Unknown | 0.66 | 0.48 | 0.93 | 0.016 | |
| Educational Attainment (Percent No High School Degree 2008–2012) |
≥21.0% | REF | |||
| 13.0–20.9% | 1.01 | 0.88 | 1.16 | 0.897 | |
| 7.0–12.9% | 1.01 | 0.85 | 1.18 | 0.950 | |
| <7.0% | 1.00 | 0.80 | 1.23 | 0.962 | |
| Income | 1st Quartile | REF | |||
| 2nd Quartile | 1.13 | 0.97 | 1.32 | 0.110 | |
| 3rd Quartile | 1.20 | 1.00 | 1.42 | 0.045 | |
| 4th Quartile | 1.09 | 0.90 | 1.32 | 0.404 | |
| County Categorization | Metro | REF | |||
| Urban | 0.83 | 0.70 | 0.97 | 0.019 | |
| Rural | 0.75 | 0.54 | 1.04 | 0.085 | |
| Distance from patient’s residence to hospital (miles) | <5 | REF | |||
| 5–30 | 1.35 | 1.19 | 1.53 | <0.001 | |
| >30 | 2.55 | 2.17 | 3.00 | <0.001 | |
| Charlson-Deyo Comorbidity Score | 0 | REF | |||
| 1 | 1.25 | 1.12 | 1.40 | <0.001 | |
| 2 | 1.02 | 0.85 | 1.23 | 0.800 | |
| 3 | 0.74 | 0.57 | 0.97 | 0.031 | |
| Diagnosis Year | 2004–2010 | REF | |||
| 2011–2017 | 1.40 | 1.26 | 1.55 | <0.001 | |
| Primary Site | Glottis | REF | |||
| Supraglottis | 0.51 | 0.45 | 0.58 | <0.001 | |
| Subglottis | 0.86 | 0.68 | 1.09 | 0.202 | |
| Laryngeal cartilage | 0.36 | 0.09 | 1.49 | 0.159 | |
| Overlapping lesions of larynx | 1.99 | 1.65 | 2.40 | <0.001 | |
| Larynx, NOS | 0.76 | 0.66 | 0.88 | <0.001 | |
| Clinical nodal stage | N0 | REF | |||
| N1 | 0.78 | 0.68 | 0.89 | <0.001 | |
| N2 | 0.67 | 0.59 | 0.76 | <0.001 | |
| N3 | 0.21 | 0.15 | 0.30 | <0.001 | |
| Tumor HPV Category | Negative | REF | |||
| Positive | 0.80 | 0.57 | 1.12 | 0.195 | |
| Unknown | 0.88 | 0.76 | 1.02 | 0.094 |
LCI: Lower Confidence Interval; UCI: Upper Confidence Interval; NOS: not otherwise specified.