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Preoperative anemia displays a dose‐dependent effect on complications in head and neck oncologic surgery
Author(s) -
Abt Nicholas B.,
Tarabanis Constantine,
Miller Ashley L.,
Puram Sidharth V.,
Varvares Mark A.
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25788
Subject(s) - medicine , hematocrit , anemia , complication , odds ratio , incidence (geometry) , surgery , dehiscence , myocardial infarction , pneumonia , logistic regression , wound dehiscence , physics , optics
Anemia's effect on head and neck surgical complications is unknown. Methods Head and neck cancer operations were acquired from the 2006 to 2013 American College of Surgeons National Surgical Quality Improvement Program databases. Anemia was defined as <39% or <36% hematocrit in men and women, respectively. Multivariable logistic regression analyses were performed. Results Major head and neck surgery patients had a 44.2% anemia incidence (n = 527 of 1193). Anemic patients had increased complication rates (27.1%) and mortality (2.1%) vs non‐anemic patients at 19.8% ( P = .003) and 0.5% ( P = .009), respectively. There was a significant difference in morbidity odds with hematocrit >27% (odds ratio [OR] = 1.09) vs <27% (OR = 4.22). Complication odds were further increased with hematocrit between 24% and 27% (OR = 8.94). There were increased rates of wound dehiscence (6.6% vs 2.7%, P < .001), pneumonia (8.5% vs 4.7%, P = .006), and myocardial infarction (1.7% vs 0.3%, P = .01) in anemic vs non‐anemic patients. Conclusion Anemia was associated with increased morbidity at hematocrit <27%. An inverse dose‐dependent effect of decreasing hematocrit was observed for overall morbidity.