Preoperative laboratory data are associated with complications and surgical site infection in composite head and neck surgical resections

Abt, Nicholas B.; Sethi, Rosh K.V.; Puram, Sidharth V.; Varvares, Mark A.

doi:10.1016/j.amjoto.2018.01.017

Cited by 9 publications

(14 citation statements)

References 17 publications

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“…Due to this, POTCT has been used as a reliable marker of complications in urologic and colorectal surgery 7–9 . Similarly, preoperative thrombocytosis has also been used as a marker to predict postoperative complications, possibly due to underlying inflammatory responses that can inhibit wound‐healing 11–13 …”

Section: Discussionmentioning

confidence: 99%

Thrombocytosis Predicts Surgical Site Infection in Head and Neck Microvascular Surgery‐ A Pilot Study

et al. 2021

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Objective/Hypothesis Early and objective prediction of complications in head and neck reconstructive surgery could decrease morbidity and prolonged hospital stays but unfortunately most complications are not identified until their effect is fully realized. There are limited data regarding the association of platelet levels and post‐operative complications. Post‐operative thrombocytosis (POTCT) is proposed as a possible indicator for complications following free‐flap reconstruction. Study Design Retrospective review. Methods A multisite retrospective chart review of patients undergoing free tissue transfer between 2013 and 2018 was undertaken. POTCT was recorded and data normalized between institutions. Data were compared between groups using t‐tests and logistic regression (P < .05). A lag‐1 difference was used to compare the rate of change in platelet values. Results A total of 398 patients were included. POTCT and a rate of change of 30 K between POD5 and POD6 was significantly associated with the presence of post‐operative complication (P = .007). Additionally, lag‐1 difference demonstrated a significant association of change in daily platelet counts and complication rates. Conclusions Isolated POTCT may be an early predictor of complications in HNC patients undergoing free‐flap reconstruction. Level of Evidence 4 Laryngoscope, 131:1542–1547, 2021

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Section: Discussionmentioning

confidence: 99%

Thrombocytosis Predicts Surgical Site Infection in Head and Neck Microvascular Surgery‐ A Pilot Study

et al. 2021

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“…1 The impact of preoperative laboratory values on ablative and reconstructive surgery is being actively investigated. 12 The precise effect of anemia on overall short-term morbidity and mortality remains unclear within the head and neck oncologic population. Therefore, the purpose of this study was to characterize the effect of preoperative anemia on morbidity and mortality in patients undergoing head and neck cancer operations.…”

Section: Introductionmentioning

confidence: 99%

“…4 Within head and neck surgery, anemia has been associated with decreased survival in laryngeal cancer 3 and oropharyngeal cancers. 11 Although hematocrit concentrations are measured over 90% of the time before major head and neck surgery, 12 few studies have examined the implications of preoperative anemia on postoperative outcomes. 1 The impact of preoperative laboratory values on ablative and reconstructive surgery is being actively investigated.…”

Section: Introductionmentioning

confidence: 99%

Preoperative anemia displays a dose‐dependent effect on complications in head and neck oncologic surgery

et al. 2019

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Introduction Anemia's effect on head and neck surgical complications is unknown. Methods Head and neck cancer operations were acquired from the 2006 to 2013 American College of Surgeons National Surgical Quality Improvement Program databases. Anemia was defined as <39% or <36% hematocrit in men and women, respectively. Multivariable logistic regression analyses were performed. Results Major head and neck surgery patients had a 44.2% anemia incidence (n = 527 of 1193). Anemic patients had increased complication rates (27.1%) and mortality (2.1%) vs non‐anemic patients at 19.8% (P = .003) and 0.5% (P = .009), respectively. There was a significant difference in morbidity odds with hematocrit >27% (odds ratio [OR] = 1.09) vs <27% (OR = 4.22). Complication odds were further increased with hematocrit between 24% and 27% (OR = 8.94). There were increased rates of wound dehiscence (6.6% vs 2.7%, P < .001), pneumonia (8.5% vs 4.7%, P = .006), and myocardial infarction (1.7% vs 0.3%, P = .01) in anemic vs non‐anemic patients. Conclusion Anemia was associated with increased morbidity at hematocrit <27%. An inverse dose‐dependent effect of decreasing hematocrit was observed for overall morbidity.

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“…Additionally, valuable insights can be elucidated from analyzing the association between various clinical/demographic factors and complications. [14][15][16] As such, this study utilized a large national database to evaluate short-term complications as well as readmission and reoperation rates following transcervical diverticulectomies of HD, and to evaluate the demographic or clinical variables that may predict these outcomes.…”

Section: Introductionmentioning

confidence: 99%

Early Adverse Events Following Transcervical Hypopharyngeal Diverticulum Surgery

Goshtasbi

Verma

2020

Ann Otol Rhinol Laryngol

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Objective: To describe rates of short-term morbidity following transcervical surgical treatment of hypopharyngeal diverticulum (HD) and analyze predictors of adverse events. Methods: The 2005 to 2017 National Surgical Quality Improvement Program database was queried to identify patients diagnosed with HD undergoing open transcervical diverticulectomy. Results: A total of 597 patients with a mean age of 71.4 ± 12.3 years were included. Thirty-day adverse events were experienced by 63 (10.6%) subjects, including 6.5% unplanned reoperations, 4.2% surgical complications, 4.4% medical complications, 2.7% readmissions, and 0.7% deaths. Medical complications notably included pneumonia (2.0%), reintubation (1.2%), sepsis (1.2%), intubation >48 hours (0.5%), urinary tract infection (0.5%), or deep vein thrombosis (0.5%), while surgical complications included organ/space infection (2.0%) and superficial (1.3%) or deep (1.0%) surgical site infection. Gender, race, functional status, diabetes, dyspnea, hypertension, steroid use, and recent weight loss were not associated with adverse events. Length of operation and hospitalization were both higher among those with adverse events (127.4 ± 107.9 vs 95.7 ± 59.8 minutes, P = 0.027, and 7.4 ± 7.4 vs 2.8 ± 3.6 days, P < 0.001). On multivariable logistic regression, high American Society of Anesthesiologists (ASA) class (OR = 2.02, P = 0.017), smoking (OR = 2.10, P = 0.044), and operation time (OR = 1.01; P = 0.005) were independent predictors of adverse events. Obesity was not associated with length of stay, readmission/reoperation, or complications. However, increased age was associated with shorter operations ( P = 0.020), higher length of hospitalization ( P < 0.001), and higher mortality ( P = 0.027) and readmission rates ( P = 0.023). Conclusion: Understanding clinical factors associated with complications following open surgery for HD such as ASA score, smoking status, length of operation, and age can help optimize surgical outcomes for at-risk patients. Level of Evidence: NA

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Preoperative laboratory data are associated with complications and surgical site infection in composite head and neck surgical resections

Cited by 9 publications

References 17 publications

Thrombocytosis Predicts Surgical Site Infection in Head and Neck Microvascular Surgery‐ A Pilot Study

Thrombocytosis Predicts Surgical Site Infection in Head and Neck Microvascular Surgery‐ A Pilot Study

Preoperative anemia displays a dose‐dependent effect on complications in head and neck oncologic surgery

Early Adverse Events Following Transcervical Hypopharyngeal Diverticulum Surgery

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