Age as a Prognostic Factor for Complications of Major Head and Neck Surgery

Boruk, Marina; Chernobilsky, Boris; Rosenfeld, Richard M.; Har‐El, Gady

doi:10.1001/archotol.131.7.605

Cited by 102 publications

(101 citation statements)

References 20 publications

(26 reference statements)

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“…Three studies calculated CCI scores (3,21,22) and only one study used the KFI (11). Therefore, the comorbidity-complication analysis of the review was based on the ASA scoring system.…”

Section: Methodsmentioning

confidence: 99%

Microvascular tissue transfers in the elderly: safety analysis for a challenging area

et al. 2017

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Background/Aim: Due to increased average life expectancy, the number of elderly patients requiring complex reconstructive microsurgical procedures is rising. Age, comorbid conditions, and location of operation are all possible risk factors. The aim of this study is to evaluate surgical outcomes to set the right criteria.Materials and methods: Between 1996 and 2014, the data of 30 patients over the age of 70, who were treated with microsurgical techniques in our clinic, were extracted from patient records and analyzed retrospectively. Results:In this patient population, flap success rate was 94%. Systemic and surgical complication rates were 40% and 48%, respectively. Complication rates were higher in head and neck cases but there was no statistically significant difference compared to reconstructions in other areas. Loss of oral lining, as a serious complication, had no effect on complications in head and neck reconstruction patients in our series.Conclusions: Flap success is comparable to younger age groups but procedures are associated with a high rate of complications Evaluating and controlling comorbid conditions is important. The American Society of Anesthesiologists scoring system is reliable in this patient population. Although complications are more common, these procedures can be performed safely in elderly populations with careful patient selection.

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“…Three studies calculated CCI scores (3,21,22) and only one study used the KFI (11). Therefore, the comorbidity-complication analysis of the review was based on the ASA scoring system.…”

Section: Methodsmentioning

confidence: 99%

Microvascular tissue transfers in the elderly: safety analysis for a challenging area

et al. 2017

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“…Age and sex were not prognostic factors in our study. Studies on head and neck tumors have shown no difference in outcome in older patients when compared with the younger patients [12,13]. Though TNM classification has been universally accepted as a tool to predict survival rates we did not find it useful in our study.…”

Section: Discussionmentioning

confidence: 57%

A Novel Morbidity Prediction Model for Head and Neck Oncosurgery

et al. 2010

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The purpose of the study was to construct and validate a risk model to predict morbidity in head and neck oncosurgeries. Potential risk factors of 300 surgically treated head and neck cancer patients like age, sex, tumor site, TNM stage, duration of surgery, adjunctive treatment, comorbidities and alcohol and tobacco usage were analyzed. Postoperative complications were noted. We developed a logistic model to predict the probability of patients developing morbidity based on the statistically significant variables-duration of surgery, preoperative radiation and hypertension. The validity of the test was assessed by the cindex which were 0.79 (95% C.I 0.71-0.87) for the study set (250 patients) and 0.86(95% C.I 0.73-0.90) for the test set (50 patients). The correlation of observed to expected morbidity was 0.709 (P<0.0001). We validated a risk model and constructed a simple chart that provides us an assessment of the risk of a patient of developing morbidity.

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“…Most importantly, the functional outcomes were similar between old and young patients (Nao et al, 2011). In an article investigating the impact of age on patients submitted to major head and neck procedures, age wasn't considered as a major prognostic factor for surgical outcome (Boruk et al, 2005). In our own experience, age is no longer considered as significant when considering the reconstruction modality to be employed, being replaced by performance-status evaluation.…”

Section: Wwwintechopencommentioning

confidence: 94%