Author(s)
Priyanka Singh BA
Simran Ohri BS
Chan Park MD
Affiliation(s)
Rutgers New Jersey Medical School;
Abstract:
Objectives: To assess the impact of race and ethnicity on 30-day complications following head and neck free flap surgery.
Methods: All cases of head and neck free flap procedures from 2005-2018 were queried from the National Surgical Quality Improvement Program (NSQIP) database. Demographics, comorbidities, and post-operative complications between race/ethnicity cohorts were compared using univariate and binary logistic regression analyses.
Results: A total of 2,034 cases were included, consisting of 86.6% White, 6.2% Black, 2.7% Asian, 2.7% Hispanic, 0.4% American Indian/Alaska Native, and 1.4% Other. Univariate analysis demonstrated significant differences across racial groups in age (p=.002), incidence of diabetes (p=.037), smoking (p<.001), steroid use (p=.035), recent weight loss (p=.004), and disseminated cancer (p=.019). Post hoc analysis on univariate analyses showed that Black patients had higher rates of smoking compared to White and Asian patients (p<.001) and American Indian patients had increased rates of steroid use compared to White (p=.040), Black (p=.035), and Asian (p=.012) patients. A binary logistic regression model adjusting for sex, age, and comorbidities indicated that Hispanic patients had increased odds of postoperative pneumonia compared to White patients (p<.001) and Black patients had increased odds of bleeding (p<.001), surgical (p=.006), and all complications (p=.038) compared to White patients.
Conclusion: Black race may be an independent predictor of increased bleeding, surgical, and all complications in head and neck free flap surgery. Further research and a larger sample size is needed to understand the role of racial disparities in head and neck free flap surgeries.