METHODS: We performed a retrospective cohort study of patients with free flap reconstruction of head and neck cancer between September 2015 and April 2023 admitted to the ICU of Beijing Tongren Hospital. The univariate and multivariate analyses were used to explore the risk factors for postoperative complications related to free flap reconstruction admitted to ICU, including flap necrosis, bleeding, fistula, and infection.
RESULTS: A total of 239 patients were included in this study, and 38 (15.9%) patients had postoperative complications related to free flap reconstruction. The median length of ICU stay was 1 day (interquartile range, 1-2 days). Multivariate analysis found that low BMI (P < 0.001), high postoperative CRP (P = 0.005), low hemoglobin (P = 0.012), and inadequate fluid intake (P < 0.05) were independent risk factors for complications.
CONCLUSIONS: Postoperative complications related to free flap reconstruction were common in this ICU population. Careful fluid management and monitoring of CRP and hemoglobin levels may reduce complications.
方法:我们对2015年9月至2023年4月北京同仁医院ICU收治的头颈部肿瘤游离皮瓣重建患者进行回顾性队列研究。采用单因素和多因素分析探讨ICU游离皮瓣重建术后并发症的危险因素。包括皮瓣坏死,出血,瘘管,和感染。
结果:本研究共纳入239例患者,38例(15.9%)患者出现游离皮瓣重建相关的术后并发症。ICU住院时间中位数为1天(四分位距,1-2天)。多因素分析发现低BMI(P<0.001),术后CRP升高(P=0.005),低血红蛋白(P=0.012),液体摄入不足(P<0.05)是并发症发生的独立危险因素。
结论:与游离皮瓣重建相关的术后并发症在ICU人群中很常见。仔细的液体管理和CRP和血红蛋白水平的监测可以减少并发症。