title: Predicting postoperative morbidity and mortality by model for endstage liver disease score for patients with head and neck cancer and liver cirrhosis.
abstract: 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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Huang-Kai
authors.initials: HK
authors.lastname: Kao
authors.forename: Li-Fei
authors.initials: LF
authors.lastname: Guo
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
authors.forename: I-How
authors.initials: IH
authors.lastname: Chen
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Ku-Hao
authors.initials: KH
authors.lastname: Fang
authors.forename: Jau-Song
authors.initials: JS
authors.lastname: Yu
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Chang
mesh_terms: 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