Correlation between intraoperative hypothermia and perioperative morbidity in patients with head and neck cancer

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Abstract

Objective: To determine if intraoperative hypothermia correlates with perioperative complications in patients undergoing head and neck surgery with regional or free flap reconstructions. Design: Retrospective medical chart review. Setting: Academic tertiary care hospital. Patients: A sample of 136 patients who underwent ablative surgery for head and neck cancer and subsequently required reconstruction with free tissue or a regional flap in the last 10 years. Main Outcome Measures: Rate of early (within 3 weeks of surgery) perioperative complications and its correlation with patient hypothermia (core body temperature, <35°C). Results: There were 43 patients with complications. Two patients died. Complications included 10 partial or total flap losses, 9 hematomas, 8 episodes of pneumonia, 7 fistulas, 7 wound infections, 5 wound breakdowns, and 2 cerebrospinal fluid leaks. Factors that did not correlate with complications included having received prior chemotherapy (P=.84), having stage IV cancer (P=.16), sex (P=.43), tobacco use (P=.58), prior radiotherapy (P=.30), the presence of comorbidities (P=.43), age (P=.27), length of surgery (P=.63), and the use of blood products perioperatively (P=.73). Patients who were hypothermic had a significantly higher rate of complications that normothermic patients (P=.002). Stepwise logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio, 5.122; 95% confidence interval, 1.317-19.917). Conclusions: Intraoperative hypothermia in head and neck surgery is correlated with perioperative complications. Maintaining normothermia through aggressive warming may decrease the incidence of perioperative morbidity for these patients.

Original languageEnglish (US)
Pages (from-to)682-686
Number of pages5
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume135
Issue number7
DOIs
StatePublished - Jul 2009

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Head and Neck Neoplasms
Hypothermia
Morbidity
Neck
Head
Free Tissue Flaps
Tobacco Use
Wound Infection
Tertiary Healthcare
Body Temperature
Tertiary Care Centers
Hematoma
Fistula
Comorbidity
Pneumonia
Radiotherapy
Logistic Models
Odds Ratio
Regression Analysis
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

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title = "Correlation between intraoperative hypothermia and perioperative morbidity in patients with head and neck cancer",
abstract = "Objective: To determine if intraoperative hypothermia correlates with perioperative complications in patients undergoing head and neck surgery with regional or free flap reconstructions. Design: Retrospective medical chart review. Setting: Academic tertiary care hospital. Patients: A sample of 136 patients who underwent ablative surgery for head and neck cancer and subsequently required reconstruction with free tissue or a regional flap in the last 10 years. Main Outcome Measures: Rate of early (within 3 weeks of surgery) perioperative complications and its correlation with patient hypothermia (core body temperature, <35°C). Results: There were 43 patients with complications. Two patients died. Complications included 10 partial or total flap losses, 9 hematomas, 8 episodes of pneumonia, 7 fistulas, 7 wound infections, 5 wound breakdowns, and 2 cerebrospinal fluid leaks. Factors that did not correlate with complications included having received prior chemotherapy (P=.84), having stage IV cancer (P=.16), sex (P=.43), tobacco use (P=.58), prior radiotherapy (P=.30), the presence of comorbidities (P=.43), age (P=.27), length of surgery (P=.63), and the use of blood products perioperatively (P=.73). Patients who were hypothermic had a significantly higher rate of complications that normothermic patients (P=.002). Stepwise logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio, 5.122; 95{\%} confidence interval, 1.317-19.917). Conclusions: Intraoperative hypothermia in head and neck surgery is correlated with perioperative complications. Maintaining normothermia through aggressive warming may decrease the incidence of perioperative morbidity for these patients.",
author = "Sumer, {Baran D.} and Myers, {Larry L.} and Joseph Leach and Truelson, {John M.}",
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T1 - Correlation between intraoperative hypothermia and perioperative morbidity in patients with head and neck cancer

AU - Sumer, Baran D.

AU - Myers, Larry L.

AU - Leach, Joseph

AU - Truelson, John M.

PY - 2009/7

Y1 - 2009/7

N2 - Objective: To determine if intraoperative hypothermia correlates with perioperative complications in patients undergoing head and neck surgery with regional or free flap reconstructions. Design: Retrospective medical chart review. Setting: Academic tertiary care hospital. Patients: A sample of 136 patients who underwent ablative surgery for head and neck cancer and subsequently required reconstruction with free tissue or a regional flap in the last 10 years. Main Outcome Measures: Rate of early (within 3 weeks of surgery) perioperative complications and its correlation with patient hypothermia (core body temperature, <35°C). Results: There were 43 patients with complications. Two patients died. Complications included 10 partial or total flap losses, 9 hematomas, 8 episodes of pneumonia, 7 fistulas, 7 wound infections, 5 wound breakdowns, and 2 cerebrospinal fluid leaks. Factors that did not correlate with complications included having received prior chemotherapy (P=.84), having stage IV cancer (P=.16), sex (P=.43), tobacco use (P=.58), prior radiotherapy (P=.30), the presence of comorbidities (P=.43), age (P=.27), length of surgery (P=.63), and the use of blood products perioperatively (P=.73). Patients who were hypothermic had a significantly higher rate of complications that normothermic patients (P=.002). Stepwise logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio, 5.122; 95% confidence interval, 1.317-19.917). Conclusions: Intraoperative hypothermia in head and neck surgery is correlated with perioperative complications. Maintaining normothermia through aggressive warming may decrease the incidence of perioperative morbidity for these patients.

AB - Objective: To determine if intraoperative hypothermia correlates with perioperative complications in patients undergoing head and neck surgery with regional or free flap reconstructions. Design: Retrospective medical chart review. Setting: Academic tertiary care hospital. Patients: A sample of 136 patients who underwent ablative surgery for head and neck cancer and subsequently required reconstruction with free tissue or a regional flap in the last 10 years. Main Outcome Measures: Rate of early (within 3 weeks of surgery) perioperative complications and its correlation with patient hypothermia (core body temperature, <35°C). Results: There were 43 patients with complications. Two patients died. Complications included 10 partial or total flap losses, 9 hematomas, 8 episodes of pneumonia, 7 fistulas, 7 wound infections, 5 wound breakdowns, and 2 cerebrospinal fluid leaks. Factors that did not correlate with complications included having received prior chemotherapy (P=.84), having stage IV cancer (P=.16), sex (P=.43), tobacco use (P=.58), prior radiotherapy (P=.30), the presence of comorbidities (P=.43), age (P=.27), length of surgery (P=.63), and the use of blood products perioperatively (P=.73). Patients who were hypothermic had a significantly higher rate of complications that normothermic patients (P=.002). Stepwise logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio, 5.122; 95% confidence interval, 1.317-19.917). Conclusions: Intraoperative hypothermia in head and neck surgery is correlated with perioperative complications. Maintaining normothermia through aggressive warming may decrease the incidence of perioperative morbidity for these patients.

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