Abt NB, et al. - In this study, researchers described normal/abnormal preoperative laboratory testing incidence in head and neck (H&N) composite resections. In addition, they determined complication, surgical site infection (SSI), and transfusion predictors by laboratory test. They observed that inflammatory markers were associated with complications but not SSI. an association of high liver function tests (LFTs) and low sodium with complications and SSI. No increased transfusion rates were observed with Coagulopathies. These findings identify laboratory studies to focus on during H&N resection preoperative assessments.

Methods

• For H&N composite resections, the 2006 to 2013 NSQIP databases were queried.
• Researchers categorized laboratory data within, under, or above the normal reference range according to NSQIP definitions.
• Multivariable logistic regression analysis was used for analyzing overall complications and SSI.

Results

• Researchers identified 1,193 H&N composite resections from 2006 to 2013.
• Of these, 1,135 (95.1%) underwent ≥1 preoperative laboratory test.
• Collection of complete blood counts was analyzed in 92.3%, basic metabolic panels in 90.7%, coagulation studies in 56.2%, and liver function tests (LFTs) in 52.6%.
• In 11.5%, they noted low sodium; this increased complication odds by 2.30 (p=0.005).
• In this study, high AST comprised 10.0% and increased complication odds (OR=2.93, p=0.012).
• Additionally, a high white blood cell (WBC) count was evident in 9.2% and high platelets in 3.5%; these increased complications by 1.92 (p=0.030) and 3.13 (p=0.015), respectively.
• Postoperative complications were not influenced by BUN, creatinine, total bilirubin, albumin, alkaline phosphatase, INR, PT, and aPTT abnormal values.
• With low sodium (OR: 2.83, p=0.002), high AST (OR: 6.85, p < 0.001), and high alkaline phosphatase (OR: 5.46, p=0.007), increased SSI odds were appreciated.
• Interestingly, INR was observed to have no effect on transfusion rates.
• Transfusion odds were not changed with high PT, aPTT, or low platelets.