Table 2.
Risk Factors for Body Image Disturbance (Body Image Scale Score ≥10) at 1 Month Postoperatively and 3 Months Posttreatment.a
| BIS Score ≥10 at 1 Month Postoperatively |
BIS Score ≥10 at 3 Months Posttreatment |
|||||
|---|---|---|---|---|---|---|
| Characteristic | nb | Unadjusted OR (95% CI) | Adjustedc OR (95% CI) | nb | Unadjusted OR (95% CI) | Adjustedc OR (95% CI) |
| Sex | 51 | 49 | ||||
| Male | Reference | Reference | Reference | Reference | ||
| Female | 2.25 (0.59–8.7) | 2.20 (0.48–10.6) | 4.8 (1.3–19.8) | 4.3 (0.88–23.9) | ||
| Age, y | 51 | 49 | ||||
| 40+ | Reference | Reference | Reference | Reference | ||
| <40 | 7.6 (0.66–173.7) | 4.9 (0.24–142.7) | 6.4 (0.56–144.9) | 3.9 (0.15–124.4) | ||
| Marital status | 51 | 49 | ||||
| Married/current partner | Reference | Reference | Reference | Reference | ||
| Single, divorced, separated, widowed | 0.43 (0.09–1.7) | 0.32 (0.04–1.6) | 0.38 (0.07–1.5) | 0.23 (0.03–1.3) | ||
| BMI | 51 | 49 | ||||
| Overweight or obese | Reference | Reference | Reference | Reference | ||
| Underweight or normal | 1.6 (0.41–6.1). | 1.9 (0.39–9.5) | 0.68 (0.13–2.8) | 0.99 (0.16–5.1) | ||
| AJCC Pathologic T Classification | 51 | 49 | ||||
| 0, 1, or 2 | Reference | Reference | Reference | Reference | ||
| 3 or 4a | 8.9 (2.0–63.7) | 19.6 (2.8–352.3) | 3.15 (0.85–13.5) | 3.8 (0.8–24.2) | ||
| Reconstructive surgery | 51 | 49 | ||||
| None or dermal | Reference | Reference | Reference | Reference | ||
| Substitute rotational flap | 4.7 (0.16–144.5) | 11.1 (0.25–832.8) | 1.8 (0.07–27.2) | 1.3 (0.04–23.2) | ||
| Microvascular free flap | 6.4 (1.0–123.3) | 21.5 (1.7–1341.8) | 2.5 (0.54–18.1) | 2.3 (0.39–20.8) | ||
| Osseous microvascular free flap reconstruction | 51 | 49 | ||||
| No | Reference | Reference | Reference | Reference | ||
| Yes | 2.9 (0.50–15.7) | 22.3 (2.4–304.5) | 1.1 (0.15–6.1) | 4.7 (0.49–42.4) | ||
| Pretreatment Shame and Stigma Scale | 50 | 1.06 (1.01–1.13) | 1.06 (0.19–6.07) | 48 | 1.11 (1.04–1.21) | 1.02 (0.91–1.15) |
| Pretreatment PROMIS Emotional Distress–Anxiety SF4a | 50 | 1.15 (0.98–1.39) | 1.00 (0.80–1.25) | 48 | 1.19 (1.00–1.46) | 0.98 (0.75–1.26) |
| Pretreatment PROMIS Emotional Distress–Depression SF4a | 50 | 1.25 (1.06–1.51) | 1.08 (0.85–1.36) | 48 | 1.13 (0.96–1.34) | 0.80 (0.54–1.07) |
| Pretreatment PROMIS Satisfaction with Social Roles and Activities SF4a | 51 | 0.88 (0.77–0.98) | 0.94 (0.82–1.10) | 49 | 0.90 (0.79–1.01) | 0.98 (0.84–1.15) |
| Pretreatment PROMIS Social Isolation SF4a | 51 | 1.21 (1.01–1.49) | 1.05 (0.79–1.34) | 49 | 1.13 (0.92–1.39) | 0.88 (0.58–1.18) |
| Pretreatment Performance Status– Head and Neck, average across subscales | 50 | 0.98 (0.95–1.02) | 1.00 (0.97–1.05) | 48 | 0.97 (0.94–1.00) | 0.98 (0.95–1.02) |
| Performance Status Scale–Head and Neck, Normalcy of Diet | 50 | 48 | ||||
| 90, 100 | Reference | Reference | Reference | Reference | ||
| 0, 10, …, 80 | 1.09 (0.21–4.65) | 0.79 (0.11–4.31) | 2.11 (0.52–8.34) | 2.75 (0.46–17.14) | ||
| Performance Status Scale–Head and Neck, Public Eating | 50 | 48 | ||||
| 75, 100 | Reference | Reference | Reference | Reference | ||
| 0, 25, 50 | 2.06 (0.37–9.81) | 1.00 (0.12–6.14) | 1.45 (0.27–6.67) | 0.86 (0.10–5.35) | ||
| Performance Status Scale–Head and Neck, Understandability of Speech | 51 | 49 | ||||
| 75, 100 | Reference | Reference | Reference | Reference | ||
| 0, 25, 50 | 2.27 (0.40–11.18) | 1.22 (0.12–8.35) | 2.76 (0.58–12.73) | 1.78 (0.23–11.49) | ||
Abbreviations: AJCC, American Joint Committee on Cancer; BIS, Body Image Scale; BMI, body mass index; CI, confidence interval; OR, odds ratio.
a
Bold values are statistically significant.
b
N < 56 for certain patient-reported outcome measures (PROMs; PROMs were treated as missing if any individual question for that instrument was missing).
c
Adjusted for pretreatment Body Image Scale scores (treated as a continuous variable) using multiple logistic regression models.