Perioperative laboratory profiles predict complications after extensive head and neck reconstruction: a...

Area of Science:

• Oncologic Surgery
• Reconstructive Surgery
• Laboratory Medicine

Background:

• Head and neck cancer reconstruction is complex with unpredictable complications.
• Perioperative laboratory parameters are potential predictors of these complications.

Purpose of the Study:

• To analyze laboratory parameters as perioperative predictors of complications in oral squamous cell carcinoma (OSCC) patients undergoing resection and reconstruction.

Main Methods:

• Retrospective analysis of laboratory data from 233 OSCC patients.
• Dynamic analysis of parameters from pre-op to 49 days post-op.
• Logistic regression and random forest modeling for predictor identification.

Main Results:

• Overall complication rate was 30%, with wound dehiscence, pulmonary embolism (PE), and surgical revision being most common.
• Complicated patients showed less decrease in hemoglobin, hematocrit, and erythrocytes, with altered coagulation and electrolytes.
• Hematocrit slope, INR, and aPTT were identified as key predictors; PE linked to potassium, urea, protein; local issues to hematological parameters.

Conclusions:

• Longitudinal laboratory monitoring is crucial for predicting and managing head and neck reconstructive surgery complications.
• Integrating dynamic lab trends into multimodal models can improve risk stratification and individualized perioperative care.