Speech-language pathology care and short- and long-term outcomes of XXXX treatment in the elderly.

@entity1 @entity353 @entity55 @entity5 @entity73 @entity1282 @entity204 @entity1742
OBJECTIVES/HYPOTHESIS: To examine associations between @entity1742 ( @entity1742 ) care and pretreatment variables, swallowing and @entity73 , and survival in elderly @entity1 treated for @entity5 . STUDY DESIGN: Retrospective analysis of surveillance, epidemiology, and end results (SEER)-Medicare data. METHODS: We evaluated longitudinal data from 2,370 @entity1 diagnosed with @entity5 from 2004 to 2007 using cross-tabulations, multivariate logistic regression, and survival analysis. RESULTS: Initial treatment with total laryngectomy (odds ratio [OR]   =   3.3 [1.6-6.8]), and @entity1282 during treatment (OR   =   4.0 [2.2-7.2]) were the only significant predictors of @entity1742 care during the initial treatment period. Speech-language pathology care was more likely during the first year (OR   =   4.1 [2.7-6.0]) and second year (OR   =   1.6 [1.1-2.3]) following initial treatment; however, only 23.7% of @entity1 ever received @entity1742 care. Pretreatment tracheostomy tube placement (OR   =   2.8 [1.1-7.0]), initial treatment with total laryngectomy (OR   =   3.4 [2.0-5.6]), @entity1282 (OR   =   7.6 [5.5-10.4]), stricture (OR   =   1.9 [1.1-3.1]), interval tracheostomy tube placement (OR   =   3.5 [2.4-5.2]), and salvage surgery (OR   =   3.1 [1.6-5.8]) were significantly associated with long-term @entity1742 care. After controlling for relevant variables, @entity1742 care was associated with significant relative attenuation of the OR for @entity1282 (50%), stricture (26%), @entity353 (20%), and @entity55 (21%). Hazards ratio for @entity204 , if under @entity1742 care, was 0.83 (0.70-0.99). CONCLUSION: @entity1742 care is underutilized in elderly @entity5 @entity1 and is largely reserved for select patients in anticipation of total laryngectomy or after the onset of impaired airway and swallowing function, but is associated with improved outcomes. These data suggest a need for treatment guidelines that incorporate the routine use of @entity1742 care during the initial treatment period and beyond. LEVEL OF EVIDENCE: 2c. Laryngoscope, 2015.
