151751-Najiba-Chargi

122 CHAPTER 7 Table 2. (Continued) All patients N=616 Patients with known SMM N=413 II 167 27.1 103 24.9 IIIa 12 1.9 10 2.4 IIIb 90 14.6 59 14.3 IVa 7 1.1 7 1.7 IVb 1 0.2 0 0 V 5 0.8 4 1 *other complications: prolonged respiratory wean due to hypodynamic diaphragm, malocclusion due to flap/plate, difficulty swallowing (multiple re-admissions, hypernatremia which prompted ITU admission), elevated liver function tests e.c.i., fractured clavicle Most common non-flap-related complication was a wound infection at the recipient site (6.8%). Most complications (n=167, 27.1%) were scored as Clavien-Dindo grade 2. Ninety pa - tients (14.6%) had a Clavien-Dindo grade 3b complication which meant that the severity of their complication necessitated intervention under general anesthesia. As shown in Table 3, univariate analysis in oncological patients with surgical complications as dependent variable determined elevated NLR as a significant predictive factor (HR 1.6; 95% CI 1.1-2.3, p<0.05). In multivariate analysis elevated NLR remained a significant predictive factor for surgical com- plications (OR 1.5; 95% CI 1.01-2.3, p=0.04), independent of patients’ comorbidities and BMI. In order to get more insight in the predictive variables for different types of flap reconstructive surgeries, oncological patients were categorized into 3 subgroups of patients (with available SMMmeasurement) based on the chosen flap: RFFF, FFF and other flaps (non-RFFF, non-FFF). This yielded a RFFF subgroup with 193 patients, a FFF group with 88 patients and a group of patients with other flaps with 106 patients. Table 3 shows the univariate and multivariate analysis with surgical complications as dependent variable distinguishing predictive factors in the flap-subgroups. For RFFF surgery, multivariate analysis determined low SMM (OR 2.0; 95% CI 1.1-3.8, p=0.03) as a predictor, independent of BMI. Gender was not included in multi - variate analysis due to multicollinearity between SMM and gender, (r 2 =0.62; p<0.001). For FFF surgery, multivariate analysis distinguished the combination of elevated NLR with low SMM (OR 4.3; 95% CI 1.3-14.2, p=0.02) as a predictor for surgical complications, independent of patients’ comorbidities. For non-RFF-non-FFF-flap surgery, no predictors for complications could be distinguished.