Perioperative risk factors for one-year mortality in patients with free flap reconstruction due to cancer of the head and neck

Abstract Purpose Head and neck cancer requiring free flap reconstruction is associated with relatively high mortality. We aimed to evaluate perioperative risk factors for 1-year mortality in this patient group. Methods A single-center retrospective analysis of 204 patients operated during 2008-2018. Results A total of 47 (23.0%) patients died within 1 year. In univariate analysis there were no differences in the intraoperative course between 1-year survivors and non-survivors. Among the 1-year non-survivors, preoperative albumin level was lower (39 [36-43] vs 42 [39-44], p=0.032) and the Sequential Organ Failure Assessment(SOFA) admission score was higher (4 [3-5] vs 3 [2-4], p=0.003) compared to the 1-year survivors. Among the non-survivors the pre- and postoperative levels of leukocytes were higher (7.6 [6.7-9.5] vs 6.9 [5.5-8.4], p=0.002; 11.4 [9.0-14.2] vs 8.7 [7.2-11.3], P Conclusions One-year non-survivors had higher ASA classification, and were more often males. The postoperative inflammatory markers were higher in non-survivors while the intraoperative course did not have a significant impact on the 1-year mortality.