Analysis of outcome for elderly patients after microvascular flap surgery: a monocentric retrospective cohort study
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Analysis of outcome for elderly patients after microvascular flap surgery: a monocentric retrospective cohort study. / Hanken, Henning; Barsukov, Evgeny; Göhler, Friedemann; Sehner, Susanne; Smeets, Ralf; Beck-Broichsitter, Benedicta; Heiland, Max; Kreutzer, Kilian; Gröbe, Alexander.
in: CLIN ORAL INVEST, Jahrgang 24, Nr. 1, 01.2020, S. 193-200.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Analysis of outcome for elderly patients after microvascular flap surgery: a monocentric retrospective cohort study
AU - Hanken, Henning
AU - Barsukov, Evgeny
AU - Göhler, Friedemann
AU - Sehner, Susanne
AU - Smeets, Ralf
AU - Beck-Broichsitter, Benedicta
AU - Heiland, Max
AU - Kreutzer, Kilian
AU - Gröbe, Alexander
PY - 2020/1
Y1 - 2020/1
N2 - OBJECTIVES: Increasingly, aging societies pose a challenge, particularly in the most developed countries. This trend leads to an increasing group of old and very old patients presenting unique requirements and challenges. One of these challenges consists in reassessment and adaption of established treatment strategies for the elderly patients. There is an ongoing discussion taking place among cranio-maxillo-facial surgeons about the appropriate extent of reconstructive flap surgery for old patients.MATERIALS AND METHODS: This monocentric retrospective cohort study investigated 281 reconstructions with microvascular flaps by comparing the risk for a negative outcome, which was defined as revision, flap loss, and patient death, between three subgroups of elderly patients and younger patients. The three subgroups of elderly patients were defined as-1: young old (65-74 years), 2: old (75-84 years), and 3: oldest old (≥ 85 years). The group of the younger patients was defined by age between 50 and 64 years. Data were obtained within a defined period of 42 months.RESULTS: Significant correlations with a negative outcome were found for the variables stay on IMC/ICU, multiple flaps, and radiotherapy prior surgery. Our data showed no significant correlation between age and a higher risk for a negative outcome.CONCLUSION: Defect reconstruction with microvascular flaps in old patients is not related with a higher risk for a negative outcome.CLINICAL RELEVANCE: Independently of age, treatment with microvascular flaps is an option for all operable patients, with an indication for oncologic surgery. For optimal therapy planning, individual patient resources and preferences should be considered instead of chronologic age.
AB - OBJECTIVES: Increasingly, aging societies pose a challenge, particularly in the most developed countries. This trend leads to an increasing group of old and very old patients presenting unique requirements and challenges. One of these challenges consists in reassessment and adaption of established treatment strategies for the elderly patients. There is an ongoing discussion taking place among cranio-maxillo-facial surgeons about the appropriate extent of reconstructive flap surgery for old patients.MATERIALS AND METHODS: This monocentric retrospective cohort study investigated 281 reconstructions with microvascular flaps by comparing the risk for a negative outcome, which was defined as revision, flap loss, and patient death, between three subgroups of elderly patients and younger patients. The three subgroups of elderly patients were defined as-1: young old (65-74 years), 2: old (75-84 years), and 3: oldest old (≥ 85 years). The group of the younger patients was defined by age between 50 and 64 years. Data were obtained within a defined period of 42 months.RESULTS: Significant correlations with a negative outcome were found for the variables stay on IMC/ICU, multiple flaps, and radiotherapy prior surgery. Our data showed no significant correlation between age and a higher risk for a negative outcome.CONCLUSION: Defect reconstruction with microvascular flaps in old patients is not related with a higher risk for a negative outcome.CLINICAL RELEVANCE: Independently of age, treatment with microvascular flaps is an option for all operable patients, with an indication for oncologic surgery. For optimal therapy planning, individual patient resources and preferences should be considered instead of chronologic age.
U2 - 10.1007/s00784-019-02914-z
DO - 10.1007/s00784-019-02914-z
M3 - SCORING: Journal article
C2 - 31065813
VL - 24
SP - 193
EP - 200
JO - CLIN ORAL INVEST
JF - CLIN ORAL INVEST
SN - 1432-6981
IS - 1
ER -