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Determinants of re-operation for bleeding in head and neck cancer surgery

Published online by Cambridge University Press:  08 March 2018

E Haapio ,
I Kinnunen ,
J K E Airaksinen ,
H Irjala  and
T Kiviniemi
E Haapio*
Affiliation:
Department of Otorhinolaryngology, Turku University Hospital and University of Turku, Finland
I Kinnunen
Affiliation:
Department of Otorhinolaryngology, Turku University Hospital and University of Turku, Finland
J K E Airaksinen
Affiliation:
Heart Center, Turku University Hospital and University of Turku, Finland
H Irjala
Affiliation:
Department of Otorhinolaryngology, Turku University Hospital and University of Turku, Finland
T Kiviniemi
Affiliation:
Heart Center, Turku University Hospital and University of Turku, Finland
*
Address for correspondence: Dr Eeva Haapio, Department of Otorhinolaryngology, Turku University Hospital, Kiinamyllynkatu 4-8, FIN-20521, Turku, Finland Fax: +358 2 3132030 E-mail: [email protected]
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Abstract

Objective:

Post-operative bleeding in the head and neck area is potentially fatal. This ‘real world’ study sought to assess factors that increase the risk of re-operation for post-operative bleeding in head and neck cancer surgery.

Methods:

A total of 456 patients underwent surgery for head and neck cancer (591 operations). The primary endpoint was re-operation for bleeding.

Results:

The rate of re-operation for bleeding was 5 per cent of all operations. Re-operation for bleeding was an independent risk factor for 30-day mortality (odds ratio = 5.27, p = 0.014). Risk factors for re-operation because of bleeding included excessive (more than 4000 ml) fluid administration (over 24 hours) (p < 0.001), heavy alcohol consumption (p = 0.014), pre-operative oncological treatment (p = 0.017), advanced disease stage (p = 0.020) and higher tumour (T) classification (p = 0.034). Operations with more excessive bleeding (700 ml or more) were associated with an increased risk (p = 0.001) of re-operation for post-operative bleeding. Moreover, the risk of re-operation was significantly higher in patients undergoing microvascular surgery compared to those who had no oncological treatment pre-operatively (18 vs 6 per cent, p = 0.001).

Conclusion:

The 30-day mortality risk increased over 5-fold in patients undergoing re-operation for bleeding.

Keywords

ReoperationSurgeryPostoperative HemorrhageMortalityHead And Neck Cancer
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 4 , April 2018 , pp. 336 - 340
Copyright
Copyright © JLO (1984) Limited 2018 

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