Multi-domain analysis of non-surgical risk factors amenable to pre-operative optimization in microvascular head and neck surgery

Yue Ma, Vir Patel, Samuel DeMaria, Chris Hernandez, Stacie Deiner, John Spivack, Brett A. Miles

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article number103346
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume43
Issue number2
DOIs
StatePublished - 1 Mar 2022

Keywords

  • Complications
  • Domain analysis
  • Head and neck cancer
  • Microvascular reconstruction
  • Outcomes
  • Squamous cell carcinoma

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