Table 2.
Univariate and Multivariable Logistic Regression Analysis for Delayed PORT Initiation.
| Variable | Multivariable Odds Ratio (95% CI) | p-value |
|---|---|---|
|
| ||
| Intervention (Ref = Pre-Intervention) | ||
|
|
||
| Post-Intervention | 0.28 (0.14 – 0.56) | <0.001* |
| Health Insurance Status (Ref = Medicare) | ||
|
|
||
| Medicaid | 0.23 (0.007 – 7.31) | 0.35 |
| Private | 1.13 (0.59 – 2.18) | 0.71 |
| Uninsured | 12.46 (1.50 – 329.72) | 0.051 |
| VA | 5.56 (0.35 – 161.77) | 0.24 |
| Marital Status (Ref= Single) | ||
|
|
||
| Married/Current -Partner | 1.47 (0.66 – 3.26) | 0.34 |
| Separated/divorced | 2.21 (0.71 – 7.18) | 0.18 |
| Widowed | 1.22 (0.30 – 5.31) | 0.78 |
| Race (Ref = White) | ||
|
|
||
| Non-White | 0.64 (0.23 – 1.75) | 0.38 |
| Cancer Subsite (Ref = Oral Cavity) | ||
|
|
||
| Larynx/Hypopharynx | 0.54 (0.19 – 1.57) | 0.26 |
| Oropharynx | 2.15 (0.69 – 7.00) | 0.19 |
| Nasal Cavity/Paranasal sinuses | 0.69 (0.18 – 2.78) | 0.60 |
| Salivary | 1.26 (0.40 – 4.11) | 0.69 |
| Skin/Scalp | 1.93 (0.69 – 5.70) | 0.22 |
| Unknown primary | 1.64 (0.22 – 12.30) | 0.61 |
| Radiation with or without CRT (Ref = CRT) | ||
|
|
||
| Radiation alone | 2.92 (1.48 – 5.98) | 0.003* |
| Dental Evaluation Prior to Radiation (Ref = No) | ||
|
|
||
| Yes | 1.68 (0.68 – 4.21) | 0.27 |
| Distance to Radiation Facility (miles) | 1.002 (0.99 – 1.01) | 0.18 |
|
|
||
| Postoperative Complications (Ref = No) | ||
|
|
||
| Yes | 2.47 (1.006 – 6.52) | 0.056 |
| Radiation at VUMC (Ref = Yes) | ||
|
|
||
| No | 1.65 (0.83 – 3.31) | 0.16 |
| Pathologic Tumor Stage (Ref = Stage 1) | ||
|
|
||
| 2 | 4.19 (1.48 – 12.59) | 0.008* |
| 3 | 2.07 (0.68 – 6.50) | 0.20 |
| 4† | - | - |
| 4a | 3.43 (1.17 – 10.44) | 0.03* |
| 4b | 6.00 (0.039 – 11.75) | 0.72 |
| x | 3.69 (0.51 – 37.32) | 0.22 |
| Pathologic Nodal Stage (Ref = Stage 0) | ||
|
|
||
| 1 | 1.34 (0.53 – 3.45) | 0.54 |
| 2 | 0.73 (0.041 – 21.11) | 0.83 |
| 2a | 2.20 (0.60 – 9.13) | 0.25 |
| 2b | 1.26 (0.40 – 4.09) | 0.68 |
| 2c | 7.99 (0.13 – 5.50) | 0.81 |
| 3† | - | - |
| 3a† | - | - |
| 3b | 2.96 (1.16 – 7.90) | 0.03* |
| x | 1.06 (0.32 – 3.56) | 0.93 |
Odds ratios (OR) and 95% confidence intervals (CI) from logistic regression models evaluating predictors of delayed postoperative radiation therapy (PORT) initiation (>42 days from surgery) following curative-intent surgery for head and neck cancer (n=390). Univariate analyses examined each variable separately. The multivariable model was stratified by pathologic T stage and adjusted for intervention period, health insurance status, marital status, race, cancer subsite, treatment modality, dental evaluation, distance to radiation facility, postoperative complications, pathologic N stage, and radiation facility location. The intervention consisted of standardized discharge documentation implemented in May 2023. ORs >1 indicate increased odds of delayed PORT; ORs <1 indicate decreased odds of delay (protective effect). All patients had pathologic indication for adjuvant radiation therapy and received treatment between January 2018 and December 2023.