{
    "abstract": "The goal of this study was to conduct a multi-domain, organ system-based analysis of non-surgical comorbidities amenable to pre-operative optimization in patients undergoing free tissue transfer, in order to better understand factors that influence patient outcomes.\nRetrospective review.\nTertiary academic center.\nA retrospective analysis of 546 patients in a prospectively maintained database who underwent free tissue transfer reconstruction between 2007 and 2016 was performed. Analysis of the relationship between binary-coded system-based domains and log-transformed length of stay (LOS), rehabilitation requirement, 30-day readmission, and post-operative complications was conducted with multiple linear regression or logistic regression models.\nPoor nutritional status and the presence of anxiety/depression independently increased median hospital LOS. Endocrine and metabolic deficits, poor nutrition status, and psychiatric comorbidities were significant predictors for rehabilitation facility requirement upon discharge.\nInterventions targeted to patient psychiatric and nutritional health may yield substantially improved outcomes in the head and neck cancer population receiving free tissue transfer surgery.",
    "authors": [
        {
            "affiliation": "Department of Otolaryngology Head and Neck Surgery, UC San Francisco, San Francisco, CA, USA.",
            "firstname": "Yue",
            "initials": "Y",
            "lastname": "Ma"
        },
        {
            "affiliation": "Department of Otolaryngology Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, PA, USA.",
            "firstname": "Vir",
            "initials": "V",
            "lastname": "Patel"
        },
        {
            "affiliation": "Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Samuel.demaria@mssm.edu.",
            "firstname": "Samuel",
            "initials": "S",
            "lastname": "DeMaria"
        },
        {
            "affiliation": "Department of Medicine, Halifax Health, Daytona, FL, USA.",
            "firstname": "Chris",
            "initials": "C",
            "lastname": "Hernandez"
        },
        {
            "affiliation": "Department of Anesthesiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.",
            "firstname": "Stacie",
            "initials": "S",
            "lastname": "Deiner"
        },
        {
            "affiliation": "Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.",
            "firstname": "John",
            "initials": "J",
            "lastname": "Spivack"
        },
        {
            "affiliation": "Department of Otolaryngology Head and Neck Surgery, Northwell Health, New hyde Park, NY, USA.",
            "firstname": "Brett A",
            "initials": "BA",
            "lastname": "Miles"
        }
    ],
    "conclusions": "Interventions targeted to patient psychiatric and nutritional health may yield substantially improved outcomes in the head and neck cancer population receiving free tissue transfer surgery.",
    "copyrights": "Copyright \u00a9 2022 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.amjoto.2021.103346",
    "journal": "American journal of otolaryngology",
    "keywords": [
        "Complications",
        "Domain analysis",
        "Head and neck cancer",
        "Microvascular reconstruction",
        "Outcomes",
        "Squamous cell carcinoma"
    ],
    "methods": null,
    "publication_date": "2022-01-12",
    "pubmed_id": "35016097",
    "results": "Poor nutritional status and the presence of anxiety/depression independently increased median hospital LOS. Endocrine and metabolic deficits, poor nutrition status, and psychiatric comorbidities were significant predictors for rehabilitation facility requirement upon discharge.",
    "title": "Multi-domain analysis of non-surgical risk factors amenable to pre-operative optimization in microvascular head and neck surgery.",
    "xml": "<Element 'PubmedArticle' at 0x788504e65170>"
}