Work

Liver Disease Predicts 30‐Day Postoperative Complications in Head and Neck Microvascular Surgery

Year: 2025

Type: article

Abstract: OBJECTIVE: To investigate the association between liver disease and postoperative outcomes of head and neck microvascular free tissue transfer (MFTT) surgeries. METHODS: This retrospective cohort study queried the 2005 to 2021 American College of Surgeons National Surgical Quality Improvement Program databases. Reconstructive cases performed by otolaryngologists (CPT: 15756, 15757, 15758, 15842, 20955, 20956, 20957, 20962, 20969, 20970, 20972, 20973, 43116, 43496, 49006, and 49906) with available age values and preoperative laboratory data were included. Liver disease severity was assessed using the AST-to-platelet ratio index (APRI), a marker of liver fibrosis, and the Model for End-Stage Liver Disease-Sodium (MELD-Na), which predicts mortality. Mild liver disease (MLD) was classified as an APRI score ≥ 0.7 and a MELD-Na score < 10. Advanced liver disease (ALD) was defined as an APRI score ≥ 0.7 and a MELD-Na score ≥ 10. Univariate and multivariable logistic regression were performed. RESULTS: A total of 5459 cases met the inclusion criteria, of which 93 (1.7%) had mild liver disease, and 105 (1.9%) had advanced liver disease. Adjusted multivariable logistic regression showed that ALD was associated with a significantly higher risk of postoperative complications (OR = 1.62, p = 0.03), medical complications (OR = 2.05, p < 0.01), and return to the operating room within 30 days (OR = 1.87, p = 0.01). ALD patients also experienced prolonged hospital stays and a higher incidence of pneumonia, unplanned intubation, and acute renal failure. CONCLUSION: ALD is correlated with increased postoperative complication risks in MFTT surgeries. This study suggests that preoperative liver function assessment and optimization may mitigate surgical risks.

Source: The Laryngoscope

DOI: 10.1002/lary.32241

Authors: Anish R. Kosanam, James R. Xu, Khashayar Arianpour, Danielle Bottalico, Eric D. Lamarre

Institutions: Cleveland Clinic, Case Western Reserve University

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,840