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01-01-2020 | Microvascular Surgery | Original Article

Analysis of outcome for elderly patients after microvascular flap surgery: a monocentric retrospective cohort study

Authors: Henning Hanken, Evgeny Barsukov, Friedemann Göhler, Susanne Sehner, Ralf Smeets, Benedicta Beck-Broichsitter, Max Heiland, Kilian Kreutzer, Alexander Gröbe

Published in: Clinical Oral Investigations | Issue 1/2020

Abstract

Objectives

Increasingly, aging societies pose a challenge, particularly in the most developed countries. This trend leads to an increasing group of old and very old patients presenting unique requirements and challenges. One of these challenges consists in reassessment and adaption of established treatment strategies for the elderly patients. There is an ongoing discussion taking place among cranio-maxillo-facial surgeons about the appropriate extent of reconstructive flap surgery for old patients.

Materials and methods

This monocentric retrospective cohort study investigated 281 reconstructions with microvascular flaps by comparing the risk for a negative outcome, which was defined as revision, flap loss, and patient death, between three subgroups of elderly patients and younger patients. The three subgroups of elderly patients were defined as—1: young old (65–74 years), 2: old (75–84 years), and 3: oldest old (≥ 85 years). The group of the younger patients was defined by age between 50 and 64 years. Data were obtained within a defined period of 42 months.

Results

Significant correlations with a negative outcome were found for the variables stay on IMC/ICU, multiple flaps, and radiotherapy prior surgery. Our data showed no significant correlation between age and a higher risk for a negative outcome.

Conclusion

Defect reconstruction with microvascular flaps in old patients is not related with a higher risk for a negative outcome.

Clinical relevance

Independently of age, treatment with microvascular flaps is an option for all operable patients, with an indication for oncologic surgery. For optimal therapy planning, individual patient resources and preferences should be considered instead of chronologic age.

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Title: Analysis of outcome for elderly patients after microvascular flap surgery: a monocentric retrospective cohort study
Authors: Henning Hanken
Evgeny Barsukov
Friedemann Göhler
Susanne Sehner
Ralf Smeets
Benedicta Beck-Broichsitter
Max Heiland
Kilian Kreutzer
Alexander Gröbe
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Microvascular Surgery
Radiotherapy
Published in: Clinical Oral Investigations / Issue 1/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02914-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Analysis of outcome for elderly patients after microvascular flap surgery: a monocentric retrospective cohort study

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

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