TY - JOUR
T1 - Multi-domain analysis of non-surgical risk factors amenable to pre-operative optimization in microvascular head and neck surgery
AU - Ma, Yue
AU - Patel, Vir
AU - DeMaria, Samuel
AU - Hernandez, Chris
AU - Deiner, Stacie
AU - Spivack, John
AU - Miles, Brett A.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Purpose: The goal of this study was to conduct a multi-domain, organ system-based analysis of non-surgical comorbidities amenable to pre-operative optimization in patients undergoing free tissue transfer, in order to better understand factors that influence patient outcomes. Study design: Retrospective review. Settings: Tertiary academic center. Materials and methods: A retrospective analysis of 546 patients in a prospectively maintained database who underwent free tissue transfer reconstruction between 2007 and 2016 was performed. Analysis of the relationship between binary-coded system-based domains and log-transformed length of stay (LOS), rehabilitation requirement, 30-day readmission, and post-operative complications was conducted with multiple linear regression or logistic regression models. Results: Poor nutritional status and the presence of anxiety/depression independently increased median hospital LOS. Endocrine and metabolic deficits, poor nutrition status, and psychiatric comorbidities were significant predictors for rehabilitation facility requirement upon discharge. Conclusion: Interventions targeted to patient psychiatric and nutritional health may yield substantially improved outcomes in the head and neck cancer population receiving free tissue transfer surgery.
AB - Purpose: The goal of this study was to conduct a multi-domain, organ system-based analysis of non-surgical comorbidities amenable to pre-operative optimization in patients undergoing free tissue transfer, in order to better understand factors that influence patient outcomes. Study design: Retrospective review. Settings: Tertiary academic center. Materials and methods: A retrospective analysis of 546 patients in a prospectively maintained database who underwent free tissue transfer reconstruction between 2007 and 2016 was performed. Analysis of the relationship between binary-coded system-based domains and log-transformed length of stay (LOS), rehabilitation requirement, 30-day readmission, and post-operative complications was conducted with multiple linear regression or logistic regression models. Results: Poor nutritional status and the presence of anxiety/depression independently increased median hospital LOS. Endocrine and metabolic deficits, poor nutrition status, and psychiatric comorbidities were significant predictors for rehabilitation facility requirement upon discharge. Conclusion: Interventions targeted to patient psychiatric and nutritional health may yield substantially improved outcomes in the head and neck cancer population receiving free tissue transfer surgery.
KW - Complications
KW - Domain analysis
KW - Head and neck cancer
KW - Microvascular reconstruction
KW - Outcomes
KW - Squamous cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=85122527821&partnerID=8YFLogxK
U2 - 10.1016/j.amjoto.2021.103346
DO - 10.1016/j.amjoto.2021.103346
M3 - Article
C2 - 35016097
AN - SCOPUS:85122527821
SN - 0196-0709
VL - 43
JO - American Journal of Otolaryngology - Head and Neck Medicine and Surgery
JF - American Journal of Otolaryngology - Head and Neck Medicine and Surgery
IS - 2
M1 - 103346
ER -