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The effects of psychosocial determinants on post-operative complications of head and neck free flap patients.
Tang, Liyang; Castellanos, Carlos; Kwon, Daniel; Kokot, Niels.
Affiliation
  • Tang L; Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America. Electronic address: liyang.tang@med.usc.edu.
  • Castellanos C; Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America.
  • Kwon D; Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America.
  • Kokot N; Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America.
Am J Otolaryngol ; 44(2): 103721, 2023.
Article in En | MEDLINE | ID: mdl-36473263
ABSTRACT

PURPOSE:

Not much is known about how pre-operative psychosocial factors affect head and neck free flap outcomes. Hence, the objective of the study is to determine if a patient's pre-operative self-perception and quality of life affect post-operative complications and hospital length of stay after free flap surgery. MATERIALS AND

METHODS:

This was a prospective cohort study. Patients who underwent a free flap surgery at an academic tertiary care center between January 2021 and March 2022 were asked to fill out the Rosenberg Self Esteem Scale and the Short Form 36 Health Questionnaire before surgery. A chart review of their medical records was then performed. Analysis of the data was performed using Spearman Correlation, Fisher exact test, Mann-Whitney and Multivariate Logistic Regression on STATA 15.

RESULTS:

Sixty-one patients (73.8 % male; mean [SD; range] age 60.9 [14.0, 23.1-86.8]) who underwent free flap surgery agreed to participate in the study. Most of the participants were not Caucasian (59 %). The most common indication for surgery was malignancy (93 %). The post-operative complication rate was 34.4 % and included 3 hematoma (4.9 %), 3 free flap failure (4.9 %), 9 wound dehiscence (14.8 %), 10 salivary fistulas (16.4 %), and 3 aspiration pneumonia or chyle leak (4.9 %). There were no mortalities. The mean role limitations due to physical health subscore [SD; range], social functioning subscore, pain subscore, and general health subscore of the SF-36 were 61.9 [39.2, 0-100], 70.7 [27.5, 0-100], 62.1 [25.7, 0-100], and 67.8 [20.3, 20-100], respectively. On univariate analysis, decreased physical limitations, better social functioning, less pain and better general health were associated with fewer overall post-operative complications, but was not correlated with length of stay. This held true for social functioning and general health even in multivariate analysis accounting for age and smoking history. The mean Rosenberg Self Esteem Scale score was 24.3 [4.1, 13-30].

CONCLUSIONS:

In this study, patients with more limited social function and worse general health had more overall post-operative complications. It is important to continue to explore how pre-operative quality of life and other psychosocial factors can affect surgical outcomes.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Plastic Surgery Procedures / Free Tissue Flaps / Head and Neck Neoplasms Type of study: Observational_studies / Risk_factors_studies Aspects: Patient_preference Limits: Female / Humans / Male / Middle aged Language: En Journal: Am J Otolaryngol Year: 2023 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Plastic Surgery Procedures / Free Tissue Flaps / Head and Neck Neoplasms Type of study: Observational_studies / Risk_factors_studies Aspects: Patient_preference Limits: Female / Humans / Male / Middle aged Language: En Journal: Am J Otolaryngol Year: 2023 Document type: Article