Abstract
Background: Patients with significant medical problems requiring major otolaryngology procedures are at high risk for both medical and surgical complications. Objective: To identify risk factors associated with perioperative complications in medically compromised patients undergoing major otolaryngology procedures. Methods: Ninety-three consecutive patients with significant comorbid medical illnesses (eg, diabetes, hypertension) undergoing major head and neck surgical procedures were referred to a medical consultation center for preoperative assessment and medical management. Patient and surgical characteristics as well as perioperative complications were identified and recorded. Univariate and multivariate analyses were performed to determine which characteristics were associated with complications. Results: Thirty-two patients (34%) had postoperative complications. Twenty-six patients (28%) had serious medical complications, and 18 (19%) had surgical complications. No deaths occurred in the study population. On univariate analysis, the factors associated with all complications included history of hepatitis, flap reconstruction, oncologic surgery, preoperative radiation therapy, preoperative gastrostomy placement, intraoperative transfusion, anesthesia time (≥8 hours), and those with greater intraoperative fluid replacement and estimated blood losses. Only anesthesia time (≥8 hours) remained independently significant on multivariate analysis. A history of hepatitis and prolonged anesthesia time were the only independent predictors of medical complications. The only independent predictor of surgical complications was the volume of intraoperative fluid administered. Conclusions: Prolonged anesthesia times of 8 hours or more, a history of hepatitis, and large-volume intraoperative fluid resuscitations predicted adverse outcomes. Special care must be taken in counseling these patients preoperatively and in caring for them during their operative and postoperative course.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 505-511 |
| Number of pages | 7 |
| Journal | Archives of Otolaryngology - Head and Neck Surgery |
| Volume | 128 |
| Issue number | 5 |
| State | Published - 2002 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Otorhinolaryngology
Cite this
Predictors of perioperative complications in head and neck patients. / Farwell, D Gregory; Reilly, Dominic F.; Weymuller, Ernest A.; Greenberg, Deborah L.; Staiger, Thomas O.; Futran, Neal A.
In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 128, No. 5, 2002, p. 505-511.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictors of perioperative complications in head and neck patients
AU - Farwell, D Gregory
AU - Reilly, Dominic F.
AU - Weymuller, Ernest A.
AU - Greenberg, Deborah L.
AU - Staiger, Thomas O.
AU - Futran, Neal A.
PY - 2002
Y1 - 2002
N2 - Background: Patients with significant medical problems requiring major otolaryngology procedures are at high risk for both medical and surgical complications. Objective: To identify risk factors associated with perioperative complications in medically compromised patients undergoing major otolaryngology procedures. Methods: Ninety-three consecutive patients with significant comorbid medical illnesses (eg, diabetes, hypertension) undergoing major head and neck surgical procedures were referred to a medical consultation center for preoperative assessment and medical management. Patient and surgical characteristics as well as perioperative complications were identified and recorded. Univariate and multivariate analyses were performed to determine which characteristics were associated with complications. Results: Thirty-two patients (34%) had postoperative complications. Twenty-six patients (28%) had serious medical complications, and 18 (19%) had surgical complications. No deaths occurred in the study population. On univariate analysis, the factors associated with all complications included history of hepatitis, flap reconstruction, oncologic surgery, preoperative radiation therapy, preoperative gastrostomy placement, intraoperative transfusion, anesthesia time (≥8 hours), and those with greater intraoperative fluid replacement and estimated blood losses. Only anesthesia time (≥8 hours) remained independently significant on multivariate analysis. A history of hepatitis and prolonged anesthesia time were the only independent predictors of medical complications. The only independent predictor of surgical complications was the volume of intraoperative fluid administered. Conclusions: Prolonged anesthesia times of 8 hours or more, a history of hepatitis, and large-volume intraoperative fluid resuscitations predicted adverse outcomes. Special care must be taken in counseling these patients preoperatively and in caring for them during their operative and postoperative course.
AB - Background: Patients with significant medical problems requiring major otolaryngology procedures are at high risk for both medical and surgical complications. Objective: To identify risk factors associated with perioperative complications in medically compromised patients undergoing major otolaryngology procedures. Methods: Ninety-three consecutive patients with significant comorbid medical illnesses (eg, diabetes, hypertension) undergoing major head and neck surgical procedures were referred to a medical consultation center for preoperative assessment and medical management. Patient and surgical characteristics as well as perioperative complications were identified and recorded. Univariate and multivariate analyses were performed to determine which characteristics were associated with complications. Results: Thirty-two patients (34%) had postoperative complications. Twenty-six patients (28%) had serious medical complications, and 18 (19%) had surgical complications. No deaths occurred in the study population. On univariate analysis, the factors associated with all complications included history of hepatitis, flap reconstruction, oncologic surgery, preoperative radiation therapy, preoperative gastrostomy placement, intraoperative transfusion, anesthesia time (≥8 hours), and those with greater intraoperative fluid replacement and estimated blood losses. Only anesthesia time (≥8 hours) remained independently significant on multivariate analysis. A history of hepatitis and prolonged anesthesia time were the only independent predictors of medical complications. The only independent predictor of surgical complications was the volume of intraoperative fluid administered. Conclusions: Prolonged anesthesia times of 8 hours or more, a history of hepatitis, and large-volume intraoperative fluid resuscitations predicted adverse outcomes. Special care must be taken in counseling these patients preoperatively and in caring for them during their operative and postoperative course.
UR - http://www.scopus.com/inward/record.url?scp=0036251537&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036251537&partnerID=8YFLogxK
M3 - Article
C2 - 12003580
AN - SCOPUS:0036251537
VL - 128
SP - 505
EP - 511
JO - JAMA Otolaryngology - Head and Neck Surgery
JF - JAMA Otolaryngology - Head and Neck Surgery
SN - 2168-6181
IS - 5
ER -