Predictors of morbidity following free flap reconstruction for cancer of the head and neck

TLDR

Free flap reconstruction of head and neck cancer defects is complex with many factors that influence perioperative complications. The aim was to determine if there was an association between perioperative variables and postoperative outcome. We evaluated 185 patients undergoing free flap reconstruction following ablation of head and neck cancer between 1999 and 2001, analyzing demographic, laboratory, surgical and anesthetic variables with univariate and multivariable techniques. Ninety‑eight patients (53%) developed complications, with a major morbidity rate of 40%; major complications were predicted by age, ASA class, and smoking, while medical complications were predicted by ASA class, smoking, age, and crystalloid replacement, and surgical complications by tracheostomy, preoperative hemoglobin, and preoperative radiotherapy. © 2007 Wiley Periodicals, Inc.

Abstract

Abstract Background Free flap reconstruction of head and neck cancer defects is complex with many factors that influence perioperative complications. The aim was to determine if there was an association between perioperative variables and postoperative outcome. Methods We evaluated 185 patients undergoing free flap reconstruction following ablation of head and neck cancer between 1999 and 2001. Demographic, laboratory, surgical and anesthetic variables were analyzed using univariate and multivariable techniques. Results Ninety‐eight patients (53%) developed complications, of which 74 were considered major, giving a major morbidity rate of 40%. Predictors of major complications were increasing patient age, ASA class, and smoking. Predictors of medical complications were ASA class, smoking, age and crystalloid replacement. Predictors of surgical complications were tracheostomy, preoperative hemoglobin, and preoperative radiotherapy. Conclusion Patient age, comorbidity, smoking, preoperative hemoglobin, and perioperative fluid management are potential predictors of postoperative complications following free flap reconstruction for cancer of the head and neck. © 2007 Wiley Periodicals, Inc. Head Neck 2007