Identifying high-risk patients before head and neck oncologic surgery
B. T. Pelczar, H. G. Weed, D. E. Schuller, D. C. Young and T. E. Reilley
Department of Otolaryngology, Ohio State University, Columbus.
Patients from the Comprehensive Cancer Center of the Arthur G. James Cancer
Hospital and Research Institute, Ohio State University, Columbus, who were
undergoing major head and neck oncologic surgery were prospectively studied
to determine predictors of postoperative medical complications and wound
infection. Of 119 patients studied, 28 (24%) had at least one postoperative
medical complication. The strongest predictors of medical complication were
poor functional capacity as assessed by the Specific Activity Scale
questionnaire and alcohol abuse. Thirteen patients (11%) developed wound
infections. The strongest predictors of wound infection were an elevated
preoperative platelet count and prolonged surgery. Wound infection was the
strongest correlate of prolonged hospital stay. These findings suggest that
the Specific Activity Scale questionnaire identifies patients at risk for
medical complication, that alcohol abuse should be managed aggressively,
and that thrombocytosis identifies patients at risk for wound infection.
Complications in Head and Neck Surgery: A Meta-analysis of Postlaryngectomy Pharyngocutaneous Fistula
Paydarfar and Birkmeyer
Arch Otolaryngol Head Neck Surg 2006;132:67-72.
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Comorbidity as a Major Risk Factor for Mortality and Complications in Head and Neck Surgery
Ferrier et al.
Arch Otolaryngol Head Neck Surg 2005;131:27-32.
ABSTRACT
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Perioperative Complications, Comorbidities, and Survival in Oral or Oropharyngeal Cancer
Ribeiro et al.
Arch Otolaryngol Head Neck Surg 2003;129:219-228.
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Predictors of Perioperative Complications in Head and Neck Patients
Farwell et al.
Arch Otolaryngol Head Neck Surg 2002;128:505-511.
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Risk Factors for Postoperative Complications in Oral Cancer and Their Prognostic Implications
de Melo et al.
Arch Otolaryngol Head Neck Surg 2001;127:828-833.
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Benchmarks for Mortality, Morbidity, and Length of Stay for Head and Neck Surgical Procedures
Bhattacharyya and Fried
Arch Otolaryngol Head Neck Surg 2001;127:127-132.
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Identifying High-Risk Surgical Patients by Poor Self-Reported Exercise Tolerance
Weed et al.
Arch Intern Med 2000;160:1539-1539.
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