Thrombocytosis Predicts Surgical Site Infection in Head and Neck Microvascular <scp>Surgery‐ A</scp> Pilot Study

Harris, Brianna; Patel, Rusha; Kejner, Alexandra E.; Russell, Benjamin; Ramadan, Jad; Bewley, Arnaud F.

doi:10.1002/lary.29386

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…7,21,22 Prior studies found that infected patients may present with thrombocytosis even in the absence of other more obvious signs of infection such as an elevated white blood cell count or fever. 23,24 In agreement with the literature in other patient populations, [8][9][10] our findings suggest that thrombocytosis may be a clinical indicator of postoperative infection risk in hip fracture patients. After excluding all patients with preoperative infections and controlling for patient characteristics and comorbidities including white Thrombocytosis in the critically ill or in the setting of tissue damage after injury has been reported to put patients at increased risk of thromboembolic events.…”

Section: Discussionsupporting

confidence: 91%

“…1,2,5 Elevated platelet counts have clinically relevant effects on patient outcomes in cardiac, general, neurologic, oncologic, and vascular surgery. [6][7][8][9][10] Recently, abnormally high platelet counts were associated with major and minor Christian A. Gonzalez, BS…”

mentioning

confidence: 99%

“…Elevated platelet counts have clinically relevant effects on patient outcomes in cardiac, general, neurologic, oncologic, and vascular surgery. 6-10 Recently, abnormally high platelet counts were associated with major and minor adverse postoperative events in shoulder and total hip arthroplasties and minor adverse postoperative events in total knee arthroplasty. 11-13 A recent retrospective review of 72,306 hip fracture patients found that preoperative platelet counts <150,000/μL were associated with an increase in early mortality, which was especially pronounced in patients with platelet counts between 50,000/μL and 100,000/μL (OR 1.63 [95% CI 1.41 to 1.90], P < 0.001).…”

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confidence: 99%

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Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery

Gonzalez,

Van Rysselberghe,

Maschhoff

et al. 2024

JAAOS Glob Res Rev

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Introduction: Low platelet counts have clinically relevant effects on patient outcomes after hip fracture surgery; however, the relationship between abnormally high platelet counts and postoperative outcomes in this population is unknown. Methods: The ACS-NSQIP database was queried for patients who underwent hip fracture surgery between 2015 and 2019. Outcomes were compared between patients with normal platelet counts (150,000 to 450,000/μL) and thrombocytosis (>450,000/μL). Results: Eighty-six thousand three hundred eleven hip fracture patients were identified, of which 1067 (1.2%) had preoperative thrombocytosis. Compared with patients with normal platelet counts, patients with preoperative thrombocytosis had increased rates of 30-day mortality (6.4% vs 4.5%, P = 0.004; OR 1.15 [95% CI 0.88 to 1.50], P = 0.322) as well as increased rates and odds of readmission (11.4% vs 7.8%, P < 0.001; OR 1.35 [95% CI 1.10 to 1.65], P = 0.004) and venous thromboembolic events (3.2% vs 1.7%, P < 0.001; OR 1.88 [95% CI 1.31 to 2.71], P < 0.001). Conclusions: Hip fracture patients with preoperative thrombocytosis had increased rates of early mortality as well as increased odds of venous thromboembolic events and readmission. A patient with thrombocytosis may benefit from close postoperative surveillance and careful follow-up. Future prospective studies are needed to verify causation and investigate how to mitigate adverse outcomes in hip fracture patients with preoperative thrombocytosis.

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Section: Discussionsupporting

confidence: 91%

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confidence: 99%

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confidence: 99%

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Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery

Gonzalez,

Van Rysselberghe,

Maschhoff

et al. 2024

JAAOS Glob Res Rev

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“…Wound complications included surgical site infection (wound dehiscence or wound pus) and fistula formation. 13 Wound dehiscence was defined as the separation of the closed skin incision edge; wound pus was defined as the presence of redness and purulent secretions at the incision; fistula formation was defined as the formation of a pathological channel between the skin and the deep tissue at the wound. Physicians evaluated patients on the 6th postoperative day, at the time of discharge, and at 1 month after the operation.…”

Section: Outcome Measuresmentioning

confidence: 99%

Timing of Oral Feeding in Patients Who have Undergone Free Flap Reconstruction for Oral Cancer

Shan

Cai

et al. 2022

The Laryngoscope

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Objective: Determine the safety and effectiveness of a nasogastric tube removal plan designed to shorten nasogastric tube indwelling time after oral cancer surgery plus free flap reconstruction.Materials and Methods: A parallel randomized clinical trial was conducted from May 2021 to December 2021 at Peking University School of Stomatology. Volunteers (n = 128) were separated into four groups: non-tracheostomy control and intervention groups and tracheostomy control and intervention groups. Control patients received the conventional nasogastric tube removal plan. Non-tracheotomy intervention patients were asked to swallow 5 ml of water on the first postoperative day. If there was no coughing, they were allowed progressively increasing amounts of water for the following 2 days. The nasogastric tube was removed only after ensuring level I/II performance on the Watian water swallowing test, no "wet voice" after drinking water, no marked decrease in blood oxygen saturation after drinking, and satisfactory daily oral nutritional intake. Tracheotomy intervention patients received the same protocol plus an additional Watian water swallowing test after tracheal tube removal.Results: Nasogastric tube removal time was earlier in the intervention subgroups than in control subgroups: 5.0 AE 2.3 days versus 7.8 AE 3.9 days (p = 0.001) in non-tracheostomy patients and 9.8 AE 1.1 days versus 16.2 AE 13.0 days (p = 0.049) in tracheostomy patients. Incidence of wound complications and daily food intake were comparable between the groups. The incidence of pneumonia was lower in the tracheostomy intervention group than in the tracheostomy control group (12.5% vs. 3.1%, p = 0.162). Pharyngeal pain score was lower in tracheotomy intervention patients than in tracheotomy control patients (p = 0.029). Postoperative hospital stay was shorter in tracheotomy intervention patients than in tracheotomy control patients (p = 0.005).Conclusions: On the basis of ensuring safety and effectiveness, patients undergone free flap reconstruction for oral cancer could be offered oral intake early after surgery, which will not increase the incidence of wound complications and pneumonia or adversely affecting the oral intake of the patients; it can also help minimize pharyngeal pain and shorten postoperative hospital stay of patients with a tracheotomy.

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“…Mishra et al showed that severe bacterial infections were characterized by high platelet count levels [ 37 ]. Moreover, Harris et al found that increased levels of circulating thrombocytes could be a marker of surgical site infection in subjects that have undergone head and neck surgery [ 38 ]. Infections are associated with a high inflammatory burden, as HT is.…”

Section: Discussionmentioning

confidence: 99%

A Novel Inflammatory Marker for the Diagnosis of Hashimoto’s Thyroiditis: Platelet-Count-to-Lymphocyte-Count Ratio

et al. 2023

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Background: Hashimoto’s thyroiditis (HT) is a chronic autoimmune thyroiditis that causes systemic inflammation in the body, leading to hypothyroidism and an enlargement of the thyroid gland. Objectives: This study aims to reveal whether there is a relationship between Hashimoto’s thyroiditis and the platelet-count-to-lymphocyte-count ratio (PLR), which is used as a new inflammatory marker. Methods: In this retrospective study, we compared the PLR of the euthyroid HT group and the hypothyroid-thyrotoxic HT group to the controls. We also evaluated the values of thyroid-stimulating hormone (TSH), free T4 (fT4), C-reactive protein (CRP), aspartate transaminase (AST), alanine transaminase (ALT), white blood cell count, lymphocyte count, hemoglobin, hematocrit, and platelet count in each group. Results: The PLR of the subjects with Hashimoto’s thyroiditis was found to be significantly different from the control group (p < 0.001), with the rankings as follows: hypothyroid-thyrotoxic HT 177% (72–417) > euthyroid HT 137% (69–272) > control group 103% (44–243). In addition to the increased PLR values, an increase in CRP values was also observed, revealing a strong positive correlation between the PLR and CRP in the HT patients. Conclusion: In this study, we found out that the PLR was higher in the hypothyroid-thyrotoxic HT and euthyroid HT patients than in a healthy control group.

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Thrombocytosis Predicts Surgical Site Infection in Head and Neck Microvascular Surgery‐ A Pilot Study

Cited by 3 publications

References 15 publications

Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery

Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery

Timing of Oral Feeding in Patients Who have Undergone Free Flap Reconstruction for Oral Cancer

A Novel Inflammatory Marker for the Diagnosis of Hashimoto’s Thyroiditis: Platelet-Count-to-Lymphocyte-Count Ratio

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