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Association of prealbumin with complications after total laryngectomy with free flap reconstruction.
Tang, Anthony; Dang, Sophia; Lao, Isabella; Pandya, Sumaarg; Solari, Mario G; Maxwell, Jessica; Contrera, Kevin J; Zevallos, Jose P; Ferris, Robert; Kim, Seungwon; Sridharan, Shaum; Spector, Matthew E.
Afiliação
  • Tang A; University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America.
  • Dang S; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America.
  • Lao I; University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America.
  • Pandya S; University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America.
  • Solari MG; University of Pittsburgh Medical Center, Department of Plastic Surgery, Pittsburgh, PA, United States of America.
  • Maxwell J; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America.
  • Contrera KJ; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America.
  • Zevallos JP; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America.
  • Ferris R; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America.
  • Kim S; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America.
  • Sridharan S; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America.
  • Spector ME; University of Pittsburgh Medical Center, Department of Otolaryngology-Head and Neck Surgery, Pittsburgh, PA, United States of America. Electronic address: spectorme@upmc.edu.
Am J Otolaryngol ; 45(6): 104451, 2024 Jul 31.
Article em En | MEDLINE | ID: mdl-39137698
ABSTRACT

OBJECTIVE:

Malnutrition is an important risk factor for patient surgical outcomes. This is especially true for head and neck cancer (HNC) patients receiving a total laryngectomy with free flap reconstruction (TLwFFR). Preoperative prealbumin and albumin values have both been used to indicate poor nutrition. This study aims to identify the prognostic value of preoperative prealbumin and albumin levels with wound healing complications in HNC patients after TLwFFR.

METHODS:

A retrospective review was conducted in all HNC patients who underwent TLwFFR from 2016 to 2022 at a tertiary-care institution. Patients with either preoperative (within 1 month of surgery) prealbumin or albumin lab values were included. Low preoperative prealbumin (low prealbumin) levels and low preoperative albumin (low albumin) levels were defined as ≤20 mg/dL and <3.4 g/dL, respectively. Outcomes collected included all wound healing complications (infection, wound dehiscence, pharyngocutaneous fistula). The association between prealbumin and albumin with outcomes were analyzed using multivariable logistic regression.

RESULTS:

A total of 83 patients met the inclusion criteria. The mean age at surgery was 61.6 ± 9.3. The overall wound healing complication rate was 33.7 %. There was an association between low prealbumin levels and any wound healing complication. On multivariate analysis, low prealbumin levels were associated with postoperative wound healing complications (OR, 4.7; CI 1.3-17.0. P = 0.02) after controlling for low albumin level, age, smoking, and preoperative radiation.

CONCLUSIONS:

Low prealbumin levels were associated with wound healing complications in TLwFFR patients. Consideration of consistent prealbumin testing with nutritional intervention may reduce wound healing complications.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Am J Otolaryngol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Am J Otolaryngol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos