Table 1. Distribution of Characteristics and Their Association With Study Outcomes.
| Factor | All Participants (N = 376) | Odds Ratio (95% CI) | ||
|---|---|---|---|---|
| 30-d Severe Complication (n = 193 [51%]) | 90-d Mortality (n = 30 [8%]) | 90-d Functional Decline (n = 36 [11%])a | ||
| Preoperative Factors | ||||
| Age, median (range), y | 83 (80-98) | 1.05 (0.99-1.11) | 1.20 (1.12-1.28) | 0.96 (0.84-1.10) |
| Sex, No. (%) | ||||
| Male | 253 (67.3) | 1.01 (0.76-1.33) | 1.67 (0.81-3.45) | 0.71 (0.31-1.63) |
| Female | 123 (32.7) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| BMI, median (range) | 24.9 (14.8-47.4) | 0.95 (0.92-0.99) | 0.96 (.92-1.00) | 0.91 (0.88-0.95) |
| Prior head and neck RT, No. (%) | ||||
| No | 232 (61.7) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 144 (38.3) | 1.32 (0.82-2.12) | 2.26 (0.87-5.87) | 1.31 (0.54-3.17) |
| Smoking, No. (%) | ||||
| No | 169 (44.9) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 207 (55.1) | 1.03 (0.78-1.36) | 0.80 (0.40-1.60) | 1.00 (0.52-1.93) |
| ACE-27 score, No. (%) | ||||
| 0-1 (none to mild) | 193 (51.3) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 2-3 (moderate to severe) | 183 (48.7) | 1.83 (1.28-2.61) | 3.16 (1.15-8.68) | 0.84 (0.45-1.59) |
| Frailty, No. (%) | ||||
| <0.25 (low) | 243 (64.6) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| ≥0.25 (high) | 133 (35.4) | 1.66 (1.12-2.44) | 2.64 (0.85-8.20) | 1.55 (0.73-3.31) |
| ASA classification, No. (%)b | ||||
| 1-2 | 76 (20.2) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 3-4 | 300 (79.8) | 1.22 (0.59-2.53) | 2.42 (0.88-6.71) | 1.85 (0.60-5.72) |
| Weight loss ≥4.5 kg, No. (%) | 110 (29.3) | 1.06 (0.75-1.51) | 1.55 (0.69-3.47) | 1.65 (0.69-3.96) |
| Functional status at baseline, No. (%) | ||||
| Independent | 306 (81.4) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Dependent plus assisted living | 70 (18.6) | 1.54 (0.96-2.48) | 0.47 (0.14-1.53) | 1.70 (0.70-4.15) |
| Operative Factors | ||||
| Tumor site, No. (%) | ||||
| Scalp, facial skin, or parotid | 131 (34.8) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Maxilla, oral cavity, or oropharynx | 207 (55.1) | 1.30 (0.79-2.14) | 0.81 (0.31-2.11) | 3.03 (1.59-5.78) |
| Larynx, hypopharynx, or esophagus | 38 (10.1) | 1.58 (0.93-2.69) | 2.71 (0.86-8.57) | 2.06 (0.52-8.16) |
| Flap type, No. (%) | ||||
| Free | 281 (74.7) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Pedicle | 95 (25.3) | 0.64 (0.37-1.11) | 1.29 (0.60-2.78) | 0.71 (0.28-1.78) |
| Bony reconstruction, No. (%)c | ||||
| No | 214 (76.2) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 67 (23.8) | 0.91 (0.49-1.67) | 0.99 (0.42-2.35) | 1.47 (0.63-3.43) |
| Duration of surgery, median (range), h | 8.7 (1.5-20.8) | 1.10 (1.2-1.19) | 1.03 (0.92-1.20) | 1.15 (1.00-1.33) |
| Additional operations, No. (%) | ||||
| No | 297 (79.0) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 79 (21.0) | 5.1 (2.93-8.72) | 1.68 (0.78-3.60) | 2.80 (1.79-4.40) |
| Flap failure, No. (%) | ||||
| No | 350 (93.1) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Partial plus total | 26 (6.9) | 2.75 (1.30-5.80) | 3.08 (1.21-7.79) | 1.47 (0.63-3.46) |
| LOS, median (range), d | 8 (2-101) | 1.15 (1.10-1.20) | 1.04 (1.01-1.08) | 1.08 (1.05-1.12) |
Abbreviations: ACE-27, Adult Comorbidity Evaluation–27; ASA, American Society of Anesthesiologists; BMI, body mass index (calculated as weight in kilograms divided by square of height in meters); LOS, length of stay; RT, radiotherapy.
a
Includes 328 patients who were not dependent at baseline and were alive at 90 days.
b
Higher scores indicate worsening overall health.
c
Includes 281 patients with free flaps.