The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology

P Pohlenz; J Klatt; R Schmelzle; L Li

doi:10.1016/j.bjoms.2012.10.020

The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology

Standard

The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology. / Pohlenz, P; Klatt, J; Schmelzle, R; Li, L.

In: BRIT J ORAL MAX SURG, Vol. 51, No. 6, 01.09.2013, p. 508-13.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Pohlenz, P, Klatt, J, Schmelzle, R & Li, L 2013, 'The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology', BRIT J ORAL MAX SURG, vol. 51, no. 6, pp. 508-13. https://doi.org/10.1016/j.bjoms.2012.10.020

APA

Pohlenz, P., Klatt, J., Schmelzle, R., & Li, L. (2013). The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology. BRIT J ORAL MAX SURG, 51(6), 508-13. https://doi.org/10.1016/j.bjoms.2012.10.020

Vancouver

Pohlenz P, Klatt J, Schmelzle R, Li L. The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology. BRIT J ORAL MAX SURG. 2013 Sep 1;51(6):508-13. https://doi.org/10.1016/j.bjoms.2012.10.020

Bibtex

@article{1e1cf792d92444fca5a0bb5526ccb8ff,

title = "The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology",

abstract = "Mortality is a rare but disastrous complication of microvascular head and neck reconstruction. The investigators attempt to identify the procedure-related mortality cases and analyse the causes of death. A retrospective analysis of 804 consecutive free flap procedures during a 19-year period was performed and fatal cases were identified (n=42 deaths). Multivariate logistic regression was employed to determine the association of in-hospital mortality with patient-related characteristics. The 30-day post-operative mortality rate was 1% (8 out of 804 patients), and the in-hospital mortality rate (post-operative deaths in-hospital before or after the 30th post-operative day without discharge) was 5.2% (42 out of 804 patients). Cancer recurrence and metastases related pneumonia were the most common causes of death (n=26, 62%), followed by cardiac, pulmonary, infectious and hepatic/renal aetiologies. Logistic regression analysis revealed that patients with stage IV disease and an operation time of >9h were significantly associated with post-operative mortality. Malignancy-related conditions were the most common causes of death following free flap transfer for head and neck reconstruction. For patients with stage IV head and neck cancer, this aggressive surgical approach should be cautiously justified due to its association with post-operative mortality. To shorten the operation time, experienced microsurgical operation teams are necessary.",

keywords = "Adult, Aged, Carcinoma, Squamous Cell, Free Tissue Flaps, Germany, Head and Neck Neoplasms, Heart Arrest, Hospital Mortality, Humans, Liver Failure, Microsurgery, Middle Aged, Myocardial Infarction, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasm Staging, Operative Time, Pneumonia, Postoperative Complications, Pulmonary Embolism, Reconstructive Surgical Procedures, Renal Insufficiency, Retrospective Studies, Surgical Wound Infection",

author = "P Pohlenz and J Klatt and R Schmelzle and L Li",

year = "2013",

month = sep,

day = "1",

doi = "10.1016/j.bjoms.2012.10.020",

language = "English",

volume = "51",

pages = "508--13",

journal = "BRIT J ORAL MAX SURG",

issn = "0266-4356",

publisher = "Churchill Livingstone",

number = "6",

}

RIS

TY - JOUR

T1 - The importance of in-hospital mortality for patients requiring free tissue transfer for head and neck oncology

AU - Pohlenz, P

AU - Klatt, J

AU - Schmelzle, R

AU - Li, L

PY - 2013/9/1

Y1 - 2013/9/1

N2 - Mortality is a rare but disastrous complication of microvascular head and neck reconstruction. The investigators attempt to identify the procedure-related mortality cases and analyse the causes of death. A retrospective analysis of 804 consecutive free flap procedures during a 19-year period was performed and fatal cases were identified (n=42 deaths). Multivariate logistic regression was employed to determine the association of in-hospital mortality with patient-related characteristics. The 30-day post-operative mortality rate was 1% (8 out of 804 patients), and the in-hospital mortality rate (post-operative deaths in-hospital before or after the 30th post-operative day without discharge) was 5.2% (42 out of 804 patients). Cancer recurrence and metastases related pneumonia were the most common causes of death (n=26, 62%), followed by cardiac, pulmonary, infectious and hepatic/renal aetiologies. Logistic regression analysis revealed that patients with stage IV disease and an operation time of >9h were significantly associated with post-operative mortality. Malignancy-related conditions were the most common causes of death following free flap transfer for head and neck reconstruction. For patients with stage IV head and neck cancer, this aggressive surgical approach should be cautiously justified due to its association with post-operative mortality. To shorten the operation time, experienced microsurgical operation teams are necessary.

AB - Mortality is a rare but disastrous complication of microvascular head and neck reconstruction. The investigators attempt to identify the procedure-related mortality cases and analyse the causes of death. A retrospective analysis of 804 consecutive free flap procedures during a 19-year period was performed and fatal cases were identified (n=42 deaths). Multivariate logistic regression was employed to determine the association of in-hospital mortality with patient-related characteristics. The 30-day post-operative mortality rate was 1% (8 out of 804 patients), and the in-hospital mortality rate (post-operative deaths in-hospital before or after the 30th post-operative day without discharge) was 5.2% (42 out of 804 patients). Cancer recurrence and metastases related pneumonia were the most common causes of death (n=26, 62%), followed by cardiac, pulmonary, infectious and hepatic/renal aetiologies. Logistic regression analysis revealed that patients with stage IV disease and an operation time of >9h were significantly associated with post-operative mortality. Malignancy-related conditions were the most common causes of death following free flap transfer for head and neck reconstruction. For patients with stage IV head and neck cancer, this aggressive surgical approach should be cautiously justified due to its association with post-operative mortality. To shorten the operation time, experienced microsurgical operation teams are necessary.

KW - Adult

KW - Aged

KW - Carcinoma, Squamous Cell

KW - Free Tissue Flaps

KW - Germany

KW - Head and Neck Neoplasms

KW - Heart Arrest

KW - Hospital Mortality

KW - Humans

KW - Liver Failure

KW - Microsurgery

KW - Middle Aged

KW - Myocardial Infarction

KW - Neoplasm Metastasis

KW - Neoplasm Recurrence, Local

KW - Neoplasm Staging

KW - Operative Time

KW - Pneumonia

KW - Postoperative Complications

KW - Pulmonary Embolism

KW - Reconstructive Surgical Procedures

KW - Renal Insufficiency

KW - Retrospective Studies

KW - Surgical Wound Infection

U2 - 10.1016/j.bjoms.2012.10.020

DO - 10.1016/j.bjoms.2012.10.020

M3 - SCORING: Journal article

C2 - 23369783

VL - 51

SP - 508

EP - 513

JO - BRIT J ORAL MAX SURG

JF - BRIT J ORAL MAX SURG

SN - 0266-4356

IS - 6

ER -