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Predicting length of stay in head and neck patients who undergo free flap reconstruction
dc.contributor.authorLindeborg, Michael M.
dc.contributor.authorSethi, Rosh K. V.
dc.contributor.authorPuram, Sidharth V.
dc.contributor.authorParikh, Anuraag
dc.contributor.authorYarlagadda, Bharat
dc.contributor.authorVarvares, Mark
dc.contributor.authorEmerick, Kevin
dc.contributor.authorLin, Derrick
dc.contributor.authorDurand, Marlene L.
dc.contributor.authorDeschler, Daniel G.
dc.date.accessioned2020-07-02T20:33:05Z
dc.date.availableWITHHELD_12_MONTHS
dc.date.available2020-07-02T20:33:05Z
dc.date.issued2020-06
dc.identifier.citationLindeborg, Michael M.; Sethi, Rosh K. V.; Puram, Sidharth V.; Parikh, Anuraag; Yarlagadda, Bharat; Varvares, Mark; Emerick, Kevin; Lin, Derrick; Durand, Marlene L.; Deschler, Daniel G. (2020). "Predicting length of stay in head and neck patients who undergo free flap reconstruction." Laryngoscope Investigative Otolaryngology 5(3): 461-467.
dc.identifier.issn2378-8038
dc.identifier.issn2378-8038
dc.identifier.urihttps://hdl.handle.net/2027.42/155916
dc.description.abstractObjectiveUnderstanding 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.MethodsA 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.ResultsA 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 [C] = +4.26, P < .0001), in‐hospital PNA or UTI (C = +2.52, P = .037), wound breakdown or fistula (C = +5.0, P < .0001), surgical site infection (C = +3.54, P = .017), and prior radiation therapy (C = +2.59, P = .004).ConclusionSeveral 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.Level of Evidence2b; retrospective cohort.
dc.publisherJohn Wiley & Sons, Inc.
dc.subject.otherlength of stay
dc.subject.otherradial forearm free flap
dc.subject.otherhead and neck cancer
dc.subject.otherfree flap
dc.subject.otherfibula free flap
dc.subject.otheranterolateral thigh flap
dc.subject.otherhead and neck reconstruction
dc.titlePredicting length of stay in head and neck patients who undergo free flap reconstruction
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelOtolaryngology
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/155916/1/lio2410.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/155916/2/lio2410_am.pdf
dc.identifier.doi10.1002/lio2.410
dc.identifier.sourceLaryngoscope Investigative Otolaryngology
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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