Comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and oropharynx with microvascular soft tissue reconstruction

Background. Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. Methods. One hundred patients with an oral/oropharynx carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. Results. Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade greater than or equal to2 was a strong predictor for complications (p < .001). There were no other predictors for postoperative complications. Conclusions. Comorbidity is of great importance for prediction of postoperative complications in head and neck cancer patients, especially an ACE-27 grade greater than or equal to2. It may be concluded from these results that prevention of complications should focus on comorbidities. (C) 2003 Wiley Periodicals, Inc.