APACHE II scoring for the prediction of immediate surgical complications in head and neck cancer patients.

Abstract:

BACKGROUND:Aggressive surgical treatment of oral and oropharyngeal cancers may be compromised by significant surgical complications. Early identification of patients at risk for postoperative complications may assist in clinical decision-making. The objective of this study was to assess the value of the Acute Physiology and Chronic Health Evaluation (APACHE II) score in predicting early postoperative surgical complications. METHODS:There were 510 cases of free tissue transfer surgery identified on the Liverpool Oncology Head and Neck Database for 1995 to 2002. APACHE II data were collected independently from critical care records and by case note retrieval. The authors' main a priori outcomes were total flap failure and any immediate complication requiring further surgery (including any from hemorrhage, hematoma, partial flap failure, airways, and anastomosis exploration). RESULTS:Overall total flap loss and immediate complication rates were 6.2 percent (30 of 485) and 13.6 percent (66 of 485), respectively. APACHE II data were known for 399 operations (82 percent) and, of these, 90 percent (360 of 399) were managed postoperatively in the critical care unit. There were clear correlations between APACHE II scores with total flap loss and with other immediate complications. CONCLUSIONS:The APACHE II score is associated with immediate postoperative surgical complications involving flap compromise and thus may be a useful tool in postoperative decision-making.

journal_name

Plast Reconstr Surg

authors

Grant CA,Dempsey GA,Lowe D,Brown JS,Vaughan ED,Rogers SN

doi

10.1097/01.prs.0000259038.36210.f8

subject

Has Abstract

pub_date

2007-05-01 00:00:00

pages

1751-1758

issue

6

eissn

0032-1052

issn

1529-4242

pii

00006534-200705000-00016

journal_volume

119

pub_type

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