The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery

被引:3
作者
Rocans, Rihards P. P. [1 ,2 ]
Zarins, Janis [3 ,4 ]
Bine, Evita [1 ]
Deksnis, Renars [5 ]
Citovica, Margarita [6 ]
Donina, Simona [7 ]
Mamaja, Biruta [2 ]
机构
[1] Riga East Clin Univ Hosp, Intens Care Clin, Hipokrata St 2, LV-1079 Riga, Latvia
[2] Riga Stradins Univ, Dept Anaesthesia & Intens Care, Dzirciema St 16, LV-1007 Riga, Latvia
[3] Microsurg Ctr Latvia, Dept Hand & Plast Surg, Brivibas St 410, LV-1024 Riga, Latvia
[4] Riga Tech Univ, Balt Biomat Ctr Excellence, Pulka St 3, LV-1007 Riga, Latvia
[5] Riga East Clin Univ Hosp, Surg Oncol Clin, Hipokrata St 4, LV-1079 Riga, Latvia
[6] Riga East Clin Univ Hosp, Lab Dept, Hipokrata St 2, LV-1079 Riga, Latvia
[7] Riga Stradins Univ, Inst Microbiol & Virol, Ratsupites St 5, LV-1067 Riga, Latvia
关键词
controlling nutritional status; microvascular flap complications; reconstructive surgery; DOUBLE BURDEN; HEAD; MALNUTRITION; OUTCOMES; OBESITY; IMPACT; SUPPORT;
D O I
10.3390/jcm12144794
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Microvascular flap surgery is a widely acknowledged procedure for significant defect reconstruction. Multiple flap complication risk factors have been identified, yet there are limited data on laboratory biomarkers for the prediction of flap loss. The controlling nutritional status (CONUT) score has demonstrated good postoperative outcome assessment ability in diverse surgical populations. We aim to assess the predictive value of the CONUT score for complications in microvascular flap surgery. This prospective cohort study includes 72 adult patients undergoing elective microvascular flap surgery. Preoperative blood draws for analysis of full blood count, total plasma cholesterol, and albumin concentrations were collected on the day of surgery before crystalloid infusion. Postoperative data on flap complications and duration of hospitalization were obtained. The overall complication rate was 15.2%. True flap loss with vascular compromise occurred in 5.6%. No differences in flap complications were found between different areas of reconstruction, anatomical flap types, or indications for surgery. Obesity was more common in patients with flap complications (p = 0.01). The CONUT score had an AUC of 0.813 (0.659-0.967, p = 0.012) for predicting complications other than true flap loss due to vascular compromise. A CONUT score > 2 was indicated as optimal during cut-off analysis (p = 0.022). Patients with flap complications had a longer duration of hospitalization (13.55, 10.99-16.11 vs. 25.38, 14.82-35.93; p = 0.004). Our findings indicate that the CONUT score has considerable predictive value in microvascular flap surgery.
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页数:11
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