Predicting length of stay in head and neck patients who undergo free flap reconstruction.
anterolateral thigh flap
fibula free flap
free flap
head and neck cancer
head and neck reconstruction
length of stay
radial forearm free flap
Journal
Laryngoscope investigative otolaryngology
ISSN: 2378-8038
Titre abrégé: Laryngoscope Investig Otolaryngol
Pays: United States
ID NLM: 101684963
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
17
04
2020
revised:
09
05
2020
accepted:
15
05
2020
entrez:
30
6
2020
pubmed:
1
7
2020
medline:
1
7
2020
Statut:
epublish
Résumé
Understanding factors that affect postoperative length of stay (LOS) may improve patient recovery, hasten postoperative discharge, and minimize institutional costs. This study sought to (a) describe LOS among head and neck patients undergoing free flap reconstruction and (b) identify factors that predict increased LOS. A retrospective cohort was performed of 282 head and neck patients with free flap reconstruction for oncologic resection between 2011 and 2013 at a tertiary academic medical center. Patient demographics, tumor characteristics, and surgical and infectious complications were characterized. Multivariable regression identified predictors of increased LOS. A total of 282 patients were included. Mean age was 64.7 years (SD = 12.2) and 40% were female. Most tumors were located in the oral cavity (53.9% of patients), and most patients underwent radial forearm free flap (RFFF) reconstruction (RFFF-73.8%, anterolateral thigh flap-11.3%, and fibula free flap-14.9%). Intraoperative complications were rare. The most common postoperative complications included nonwound infection (pneumonia [PNA] or urinary tract infection [UTI]) (15.6%) and wound breakdown/fistula (15.2%). Mean and median LOS were 13 days (SD = 7.7) and 10 days (interquartile range = 7), respectively. Statistically significant predictors of increased LOS included flap take back (Beta coefficient [ Several perioperative factors are associated with increased LOS. These findings may help with perioperative planning, including the need for vigilant wound care, optimization of antibiotics prophylaxis, and institution-level protocols for postoperative care and disposition of free flap patients. 2b; retrospective cohort.
Identifiants
pubmed: 32596488
doi: 10.1002/lio2.410
pii: LIO2410
pmc: PMC7314462
doi:
Types de publication
Journal Article
Langues
eng
Pagination
461-467Informations de copyright
© 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society.
Déclaration de conflit d'intérêts
The authors declare no potential conflict of interest.
Références
Laryngoscope. 2017 Jun;127(6):1339-1344
pubmed: 28000237
Ann Plast Surg. 1999 Jun;42(6):662-4
pubmed: 10382805
JAMA Otolaryngol Head Neck Surg. 2017 Jun 1;143(6):574-579
pubmed: 28301644
Head Neck. 2010 Oct;32(10):1345-53
pubmed: 20091687
Head Neck. 1995 Jan-Feb;17(1):7-13
pubmed: 7883554
Oral Oncol. 2008 Jun;44(6):555-62
pubmed: 17936062
JAMA. 2002 Jan 23-30;287(4):487-94
pubmed: 11798371
Oral Oncol. 2010 Mar;46(3):190-4
pubmed: 20060773
Br J Plast Surg. 1996 Jul;49(5):267-73
pubmed: 8774239
Am J Otolaryngol. 2020 Mar - Apr;41(2):102392
pubmed: 31918856
Crit Care Med. 2012 Apr;40(4):1122-8
pubmed: 22067629
J Vasc Surg. 1995 Dec;22(6):649-57; discussion 657-60
pubmed: 8523599
Arch Otolaryngol Head Neck Surg. 1986 Apr;112(4):437-9
pubmed: 3484960
Otolaryngol Head Neck Surg. 2016 Feb;154(2):272-8
pubmed: 26573570
Eur Arch Otorhinolaryngol. 2013 May;270(5):1741-6
pubmed: 23081673
Infection. 2018 Apr;46(2):225-230
pubmed: 29250713
Laryngoscope. 1993 Jan;103(1 Pt 1):22-7
pubmed: 8421415
Acta Clin Belg. 2018 Feb;73(1):40-49
pubmed: 28629305
JAMA. 2010 Jun 2;303(21):2141-7
pubmed: 20516414
J Vasc Surg. 2004 Feb;39(2):395-9
pubmed: 14743142
J Craniomaxillofac Surg. 2017 Jul;45(7):1078-1082
pubmed: 28527564
Otolaryngol Head Neck Surg. 2016 Nov;155(5):733-739
pubmed: 27329425
Ann Otol Rhinol Laryngol. 2017 Jan;126(1):20-28
pubmed: 27913719
Head Neck. 2016 Apr;38 Suppl 1:E392-8
pubmed: 25641048
Ann Intern Med. 2012 Dec 18;157(12):837-45
pubmed: 23247937
JAMA Otolaryngol Head Neck Surg. 2017 Dec 1;143(12):1181-1186
pubmed: 28447103
Laryngoscope. 2018 Feb;128(2):343-349
pubmed: 28850725
J Craniomaxillofac Surg. 2009 Dec;37(8):438-42
pubmed: 19553132
JAMA Otolaryngol Head Neck Surg. 2015 Dec;141(12):1052-8
pubmed: 25905986
Plast Reconstr Surg. 1999 Feb;103(2):403-11
pubmed: 9950525
Laryngoscope. 2000 Feb;110(2 Pt 1):210-6
pubmed: 10680918
Lancet. 2016 Oct 1;388(10052):1377-1388
pubmed: 27707496
Eur Arch Otorhinolaryngol. 2010 Oct;267(10):1629-33
pubmed: 20461393
Cancer. 2017 May 15;123(10):1760-1767
pubmed: 28026864
Surg Infect (Larchmt). 2016 Feb;17(1):100-5
pubmed: 26501794