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

Jonathan R. Clark, Stuart A. McCluskey, Francis Hall, Joan Lipa, Peter Neligan, Dale Brown, Jonathan Irish, Patrick Gullane, Ralph Gilbert*

*Corresponding author for this work

Research output: Contribution to journalArticle

162 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1090-1101
Number of pages12
JournalHead and Neck
Volume29
Issue number12
DOIs
Publication statusPublished - Dec 2007
Externally publishedYes

Keywords

  • ASA
  • Charlson comorbidity index
  • Complications
  • Head and neck cancer
  • Kaplan-Feinstein index

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