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Risk factors for ev...
Risk factors for evaluating early mortality after microvascular reconstruction of head and neck cancers
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Nieminen, T (författare)
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Tolvi, M (författare)
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Lassus, P (författare)
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Wilkman, T (författare)
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Lehtonen, L (författare)
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- Makitie, A (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2022-08-24
- 2022
- Engelska.
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Ingår i: Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. - : SAGE Publications. - 1799-7267. ; 111:4, s. 83-91
- Relaterad länk:
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http://kipublication...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Free tissue transfer reconstruction carries significant complication rates in surgical head and neck oncology. A registry-based approach offers a possibility to investigate the factors affecting increased morbidity and early mortality, that is, death within 6 months of treatment. Methods: A retrospective registry review was conducted on a series of 317 consecutive microvascular free tissue transfers in head and neck cancer patients performed during 2013–2017 at the Helsinki University Hospital (Helsinki, Finland). All surviving patients had a minimum follow-up of 2 years (range 24–84 months). Results: Overall, 36 (11.4%) early deaths occurred in this series. In multivariable logistic regression analysis, patients aged 75 years and older ( p = 0.019), Adult Comorbidity Evaluation-27 (ACE-27) score of 3 ( p = 0.048), tumor class T3 ( p = 0.005), lymph node class N2 ( p = 0.014), or thrombocyte count of 360 (× 109 L) or more ( p = 0.001) were more likely to die within 6 months of surgery. Of these 36 patients, 27 (75%) had a complication warranting hospital care and most ( n = 22, 61%) had several complications. Conclusions: Early postoperative mortality most frequently affects patients aged 75 years and above, with a high ACE-27 score, advanced tumor stage, or high thrombocyte count. Therefore, preoperative assessment and patient selection should have a crucial role in this patient population.
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- art (ämneskategori)
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