Predicting postoperative morbidity and mortality by model for endstage liver disease score for patients with head and neck cancer and liver cirrhosis.
BACKGROUND
The purpose of this study was to evaluate the Model for Endstage Liver Disease (MELD) scoring system for predicting the morbidity and mortality of patients with head and neck cancer with liver cirrhosis undergoing tumor resection with microsurgical free-tissue transfer.


METHODS
Between January 2000 and December 2008, 3108 cases were retrospectively reviewed.


RESULTS
There were 59 men and 2 women enrolled in this study. Preoperatively, 31 and 30 patients were classified as having lower (<9.73) and higher (>9.73) MELD scores, respectively. Patients with higher MELD scores had significantly more postoperative medical morbidities including pulmonary complications and gastrointestinal bleeding. The mortality rate was also significantly higher for higher MELD scorers (23.3% vs 3.2%; p = 0.026). By logistic regression model, preoperative MELD score was a significant predictive factor for morbidity and mortality in multivariate analysis.


CONCLUSIONS
MELD score could be used to predict morbidity and mortality for patients with head and neck cancer with liver cirrhosis undergoing tumor resection with microsurgical free tissue transfer.
Kao
Huang-Kai
HK
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Guo
Li-Fei
LF
Cheng
Ming-Huei
MH
Chen
I-How
IH
Liao
Chun-Ta
CT
Fang
Ku-Hao
KH
Yu
Jau-Song
JS
Chang
Kai-Ping
KP
D000328:Adult; D000368:Aged; D058625:End Stage Liver Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D010039:Otorhinolaryngologic Neoplasms / Q000139:chemically induced / Q000401:mortality* / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D013524:Surgical Flaps