Determinants of re-operation for bleeding in head and neck cancer surgery.
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.
['Haapio|E|E|', 'Kinnunen|I|I|', 'Airaksinen|J K E|JKE|', 'Irjala|H|H|', 'Kiviniemi|T|T|']
D000428:Alcohol Drinking D005260:Female D006258:Head and Neck Neoplasms D006801:Humans D008297:Male D019106:Postoperative Hemorrhage D012086:Reoperation D012307:Risk Factors D015996:Survival Rate
Head And Neck Cancer Surgery Mortality Postoperative Hemorrhage Reoperation