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The Value of the Nutritional Indicators in Predicting Free Flap Failure From a Multicentre Database.
Yen, Yuan-Hao; Luo, Sheng-Dean; Chen, Wei-Chih; Li, Chung-Yi; Chiu, Tai-Jan; Wang, Yu-Ming; Wu, Shao-Chun; Yang, Yao-Hsu; Chen, Yung-Hsuan; Wu, Ching-Nung.
Afiliación
  • Yen YH; Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
  • Luo SD; Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
  • Chen WC; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Li CY; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Chiu TJ; Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
  • Wang YM; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • Wu SC; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
  • Yang YH; Department of Health care Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
  • Chen YH; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Wu CN; Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Otolaryngol Head Neck Surg ; 171(1): 63-72, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38501382
ABSTRACT

OBJECTIVE:

Nutritional and inflammatory statuses have been associated with complications in microvascular-free flaps during head and neck surgeries. This study aimed to evaluate the potential of nutritional indicators in predicting postoperative free flap complications. STUDY

DESIGN:

We conducted a 20-year retrospective, case-control study within a defined cohort.

SETTING:

The study involved head and neck cancer patients from the Chang Gung Research Database who underwent simultaneous tumor ablation and free flap wound reconstruction between January 1, 2001, and December 31, 2019.

METHODS:

We employed logistic regression and stratified analysis to assess the risk of free flap complications and the subsequent need for flap revision or redo in relation to nutritional indicators and other clinical variables.

RESULTS:

Of the 8066 patients analyzed, 687 (8.5%) experienced free flap complications. Among these, 197 (2.4%) had free flap failures necessitating a redo of either a free flap or a pedicled flap. Beyond comorbidities such as chronic obstructive pulmonary disease, end-stage renal disease, and a history of prior radiotherapy, every 10-unit decrease in the preoperative prognostic nutritional index (PNI) was consistently associated with an increased risk of both free flap complications and failure. The covariate-adjusted odds ratios were 1.90 (95% confidence interval [CI] 1.42-2.54) and 1.89 (95% CI 1.13-3.17), respectively.

CONCLUSION:

A lower preoperative PNI suggests a higher likelihood of microvascular free flap complications in head and neck surgeries. Further randomized controlled trial designs are required to establish causality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Procedimientos de Cirugía Plástica / Colgajos Tisulares Libres / Neoplasias de Cabeza y Cuello Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Procedimientos de Cirugía Plástica / Colgajos Tisulares Libres / Neoplasias de Cabeza y Cuello Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Reino Unido