Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Head Neck. 2022 Jan;44(1):168-176. doi: 10.1002/hed.26907. Epub 2021 Oct 27.
Hypertension has been shown to be both a protective factor and a risk factor for complications in head and neck reconstructive surgery.
Retrospective analysis of microvascular free tissue transfer patients using the National Surgical Quality Improvement Program database.
Hypertensive patients (n = 1598; 46.9%) had a significantly higher rate of complications, including pneumonia (p < 0.001), myocardial infarction (p = 0.003), and intra/post-operative transfusion (p < 0.001). In a multivariable model, hypertension was associated with returning to the operating room (OR = 1.45 [95% CI 1.20, 1.76], p < 0.001), post-operative medical complications (OR = 1.53 [95% CI 1.24, 1.90], p < 0.001), and surgical complications (OR = 1.17 [95% CI 1.00, 1.37], p = 0.047). However, no difference in 30-day readmission was found (p > 0.05).
Hypertension is a modifiable risk factor for post-operative complications in head and neck free tissue transfer, in which prospective studies are required to establish causation. This study may serve as an impetus for proactive recommendations to manage hypertension before undergoing head and neck microvascular surgery.
高血压已被证明既是头颈部重建手术并发症的保护因素，也是风险因素。
使用国家手术质量改进计划数据库对微血管游离组织转移患者进行回顾性分析。
高血压患者（n=1598；46.9%）并发症发生率明显较高，包括肺炎（p<0.001）、心肌梗死（p=0.003）和围手术期输血（p<0.001）。在多变量模型中，高血压与重返手术室（OR=1.45[95%CI 1.20, 1.76]，p<0.001）、术后内科并发症（OR=1.53[95%CI 1.24, 1.90]，p<0.001）和手术并发症（OR=1.17[95%CI 1.00, 1.37]，p=0.047）相关。然而，30 天再入院率无差异（p>0.05）。
高血压是头颈部游离组织转移术后并发症的一个可改变的危险因素，需要前瞻性研究来确定其因果关系。本研究可能为在进行头颈部微血管手术前积极建议管理高血压提供动力。
