title: Comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and oropharynx with microvascular soft tissue reconstruction.
abstract: BACKGROUND
  Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients.
  
  
  METHODS
  One hundred patients with an oral/oropharynx carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity.
  
  
  RESULTS
  Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade > or =2 was a strong predictor for complications (p <.001). There were no other predictors for postoperative complications.
  
  
  CONCLUSIONS
  Comorbidity is of great importance for prediction of postoperative complications in head and neck cancer patients, especially an ACE-27 grade > or =2. It may be concluded from these results that prevention of complications should focus on comorbidities.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, VU Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. pa.borggreven@vumc.nl
authors.forename: Pepijn A
authors.initials: PA
authors.lastname: Borggreven
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Kuik
authors.forename: Jasper J
authors.initials: JJ
authors.lastname: Quak
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
authors.forename: Gordon B
authors.initials: GB
authors.lastname: Snow
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D009062:Mouth Neoplasms / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D009960:Oropharynx / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome