title: Predictors of morbidity following free flap reconstruction for cancer of the head and neck.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, Toronto, Ontario, Canada. jcjc@tpg.com
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
authors.forename: Stuart A
authors.initials: SA
authors.lastname: McCluskey
authors.forename: Francis
authors.initials: F
authors.lastname: Hall
authors.forename: Joan
authors.initials: J
authors.lastname: Lipa
authors.forename: Peter
authors.initials: P
authors.lastname: Neligan
authors.forename: Dale
authors.initials: D
authors.lastname: Brown
authors.forename: Jonathan
authors.initials: J
authors.lastname: Irish
authors.forename: Patrick
authors.initials: P
authors.lastname: Gullane
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
mesh_terms: D000367:Age Factors; D001810:Blood Volume; D003102:Colloids; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017063:Outcome Assessment, Health Care; D010306:Parotid Gland / Q000601:surgery; D019990:Perioperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D013524:Surgical Flaps; D014139:Tracheostomy
chemical_list: D003102:Colloids; D006454:Hemoglobins