• Chieh-Ching Yen, Heng Yeh, Che-Fang Ho, Chien-Han Hsiao, Kuang-Yu Niu, Chung-Cheng Yeh, Jian-Xun Lu, Chia-Chien Wu, Yun-Chen Chang, and Chip-Jin Ng.
• Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
• Am J Emerg Med. 2022 Aug 1; 58: 9159-15.

BackgroundAcute head and neck cancer (HNC) bleeding is a life-threatening situation that frequently presents to the emergency department (ED). The purpose of the present study was to analyze the risk factors for the 30-day mortality in patients with HNC bleeding.MethodsWe included patients who presented to the ED with HNC bleeding (n = 241). Patients were divided into the survivor and nonsurvivor groups. Variables were compared, and the associated factors were examined with Cox's proportional hazard model.ResultsOf the 241 patients enrolled, the most common bleeding site was the oral cavity (n = 101, 41.9%). More than half of the patients had advanced HNC stage while 41.5% had local recurrence. The proportion of active bleeding was significantly higher in the nonsurvivor group (70.5% vs. 53.3%, p = 0.038). 42.3% received blood transfusion and 5.0% required inotropic support. In total, 21.2% of the patients experienced rebleeding, and 18.3% died within 30 days. Multivariate analyses indicated that a heart rate > 100 (beats/min) (HR = 2.42; Cl 1.15-5.06; p = 0.019) and inotropic support (HR = 3.00; Cl 1.14-7.89; p = 0.026) were statistically significant independent risk factors for 30-day mortality.ConclusionsThe results of this study may aid physicians in the evaluation of short-term survival in HNC bleeding patients and provide critical information for risk stratification and medical decisions.Copyright © 2022 Elsevier Inc. All rights reserved.

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