Table 3.
Risk factors for aspiration pneumonia among patients with head-and-neck cancer treated with chemoradiotherapy.
| Univariate analysis |
Multivariate analysis |
||
|---|---|---|---|
| Variables | 5-yr rate (%) | SDHR (95% CI) | SDHR (95% CI) |
| Age at diagnosis, y | |||
| 66–74 | 21.4 | Ref | Ref |
| 75–79 | 27.9 | 1.40 (1.17–1.67) | 1.37 (1.14–1.64) |
| ≥80 | 28.9 | 1.45 (1.20–1.75) | 1.49 (1.22–1.82) |
| Metropolitan area | |||
| Yes | 25.4 | 1.64 (1.31–2.06) | 1.22 (0.95–1.57) |
| No | 16.7 | Ref | Ref |
| Teaching hospital | |||
| Yes | 28.3 | 1.79 (1.53–2.09) | 1.87 (1.58–2.20) |
| No | 17.5 | Ref | Ref |
| Region | |||
| West | 25.3 | Ref | Ref |
| East | 26.6 | 1.06 (0.89–1.27) | 0.89 (0.73–1.08) |
| Midwest | 26.6 | 1.04 (0.82–1.30) | 0.86 (0.67–1.09) |
| South | 18.7 | 0.67 (0.55–0.81) | 0.75 (0.60–0.92) |
| Median Income | |||
| Bottom quartile | 19.9 | Ref | Ref |
| 2nd quartile | 23 | 1.17 (0.94–1.46) | 1.24 (0.98–1.55) |
| 3rd quartile | 25.2 | 1.31 (1.06–1.62) | 1.25 (1.00–1.57) |
| Top quartile | 27.9 | 1.54 (1.25–1.89) | 1.37 (1.09–1.73) |
| Sex | |||
| Male | 25.4 | 1.27 (1.08–1.50) | 1.31 (1.09–1.56) |
| Female | 20.2 | Ref | Ref |
| Race | |||
| White | 23.5 | Ref | Ref |
| Black | 24.8 | 1.01 (0.79–1.29) | 1.07 (0.82–1.41) |
| Other | 28.8 | 1.31 (1.01–1.71) | 1.06 (0.80–1.41) |
| Marital status | |||
| Married | 24 | 1.01 (0.88–1.17) | 0.94 (0.81–1.10) |
| Other | 23.8 | Ref | Ref |
| Charlson comorbidity score | |||
| 0 | 22.1 | Ref | Ref |
| 1 | 23.9 | 1.09 (0.92–1.29) | 1.07 (0.90–1.27) |
| 2 | 29.1 | 1.27 (1.02–1.59) | 1.26 (1.01–1.58) |
| ≥3 | NA | 1.15 (0.89–1.49) | 1.13 (0.87–1.48) |
| Year of diagnosis | |||
| 2000–2003 | 22.9 | Ref | Ref () |
| 2004–2006 | 25 | 1.10 (0.92–1.31) | 1.06 (0.87–1.30) |
| 2007–2009 | NA | 0.89 (0.74–1.06) | 0.86 (0.67–1.11) |
| Tumor site | |||
| Oral cavity | 19.9 | Ref | Ref |
| Hypopharynx | 30.5 | 1.68 (1.28–2.20) | 1.58 (1.20–2.10) |
| Larynx | 24.4 | 1.20 (0.94–1.54) | 1.16 (0.90–1.49) |
| Nasopharynx | 34.1 | 1.76 (1.23–2.50) | 1.77 (1.23–2.55) |
| Oropharynx | 23.4 | 1.16 (0.92–1.46) | 1.16 (0.91–1.47) |
| Other | 19.9 | 0.96 (0.68–1.36) | 0.94 (0.67–1.34) |
| Historic stage | |||
| Localized | 23.8 | Ref | Ref |
| Regional | 23.5 | 1.03 (0.83–1.28) | 0.99 (0.79–1.25) |
| Distant | 25.2 | 1.07 (0.83–1.38) | 1.01 (0.77–1.31) |
| Unknown | 29.4 | 1.29 (0.86–1.94) | 1.27 (0.84–1.92) |
| PET | |||
| Yes | 24.5 | 1.00 (0.86–1.15) | 0.99 (0.84–1.17) |
| No | 23.6 | Ref | Ref |
| IMRT | |||
| Yes | 24.1 | 1.00 (0.87–1.16) | 1.06 (0.88–1.26) |
| No | 23.3 | Ref | Ref |
| Surgery prior to raditaion | |||
| Yes | 20.7 | 0.83 (0.69–1.00) | 0.81 (0.67–0.99) |
| No | 24.6 | Ref | Ref |
| Sequence of chemotherapy and radiotherapy | |||
| During | 24.8 | Ref | Ref |
| During and before | 21.6 | 0.85 (0.67–1.08) | 0.86 (0.67–1.11) |
| During and after | 23.9 | 0.96 (0.81–1.14) | 0.94 (0.79–1.11) |
| During, before and after | 21.4 | 0.89 (0.63–1.26) | 0.86 (0.61–1.22) |
| Types of chemotherapy | |||
| Cetuximab | 27.7 | Ref | Ref |
| Cisplatin | 23.9 | 0.86 (0.69–1.09) | 0.89 (0.69–1.14) |
| Other | 23.3 | 0.91 (0.75–1.11) | 0.92 (0.73–1.15) |
Abbreviations: SDHR, Subdistribution Hazard Ratio; PET, Positron Emission Tomography; IMRT, Intensity-Modulated Radiation Therapy.